Sax et al. found that pericardial active ghrelin concentration and the pericardial-to-plasma ghrelin ratio were elevated in IHD patients, compared to non-ischaemic subjects, and suggested an increased ghrelin production by the chronically ischaemic myocardium.34 Gnanapavan et al. demonstrated mRNA expression of ghrelin in the myocardium and veins. The gene discussed is GHRL; the disease is myocardial ischemia.