Endothelin in cardiovascular disease: from atherosclerosis to heart failure

P J Best1, A Lerman

  • 1Department of Internal Medicine and Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

Insights

Endothelin (ET) contributes to cardiovascular diseases through various mechanisms. ET receptor antagonists offer new therapeutic strategies for conditions like coronary artery disease and heart failure.

Area of Science:

  • Cardiovascular Science
  • Endocrinology
  • Pharmacology

Background:

  • Endothelin (ET) is a potent vasoconstrictor implicated in cardiovascular disease pathogenesis.
  • ET influences vascular tone, cardiac hemodynamics, cellular proliferation, apoptosis, and matrix production.
  • The endogenous ET system plays a significant role in both physiological and pathophysiological states.

Purpose of the Study:

  • To elucidate the multifaceted role of endothelin in cardiovascular disease.
  • To highlight the therapeutic potential of endothelin receptor antagonists.
  • To deepen the understanding of the ET system's involvement in disease progression.

Main Methods:

  • Review of existing evidence on endothelin's role in cardiovascular pathophysiology.
  • Analysis of the development and application of endothelin receptor antagonists.
  • Exploration of the mechanisms by which ET affects cellular and vascular functions.

Main Results:

  • Endothelin contributes to cardiovascular diseases via multiple pathways.
  • Endothelin receptor antagonists have emerged as valuable therapeutic agents.
  • Studies on ET receptor antagonists enhance comprehension of the ET system in disease.

Conclusions:

  • Endothelin is a key mediator in the development of cardiovascular diseases.
  • Endothelin receptor antagonists represent a promising therapeutic avenue.
  • Further research into the ET system is crucial for advancing cardiovascular disease treatment.

Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...