Humoral regulation refers to the effect of hormones in the heart and how hormones that are released into the bloodstream under certain physiological states may regulate cardiac function. Catecholamines released from the adrenal medulla increase the dP/dt of the heart. This effect is potentiated by steroid hormones. Calorigenic hormones like insulin, glucagon and thyroxine also increase cardiac contractility. Thyroxine produces a permissive effect on the action of catecholamines. In hypothyroidism the effect of catecholamines in the heart is depressed by the absence of thyroxine.