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The identification of the adipocyte as a source of production of biologically active peptides has materialized into an active area of research related to the role of these peptides in physiology and pathophysiology. Moreover, this research has resulted in the identification of the adipocyte as an endocrine organ producing potent bioactive compounds. An increasing number of these adipokines are being identified, the first of which was leptin, a product of the obesity gene whose primary function is to act as a satiety factor but which is now known to exert a myriad of effects. It is now recognized that virtually all adipokines produce effects on numerous organ systems including the heart. Indeed various adipokines including leptin, adiponectin and apelin exert potent and diverse cardiovascular effects, which are mediated by their specific receptors and involving complex and multi-faceted cell signaling pathways. Here we focus primarily on the diverse effects of adipokines on the heart and discuss the potential cell signaling mechanisms underlying their actions. Current evidence suggests that the cardiac effects of adipokines can be separated into beneficial and deleterious effects and therefore discussion is also presented on the emerging role of various adipokines in cardiac pathology with an examination of the possible underlying mechanisms which contribute to these effects. The review concentrates primarily on leptin and adiponectin, which are the most studied of the adipokines in terms of cardiac effects and which appear to function in a “yin-yang” type of relationship in exerting their cardiac effects. However, other adipokines including apelin, resistin and visfatin, which are emerging as potentially important in the regulation of cardiac function, are also introduced.

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