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Endothelin receptor antagonists in cardiology clinical trials
Thomas Neunteufl1, Rudolf Berger, Richard Pacher
1Department of Cardiology, University of Vienna Medical School, Währinger Gürtel 18-20, A-1090 Vienna, Austria. thomas.neunteufl@univie.ac.at
Insights
Endothelin-1 (ET-1) is a marker for advanced heart failure and cardiovascular diseases. This review examines endothelin receptor antagonists for treating heart failure, coronary artery disease, and hypertension.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Endothelin-1 (ET-1) is elevated in advanced heart failure, acute ischemic syndromes, myocardial infarction, and pulmonary hypertension.
- ET-1 activation contributes to adverse hemodynamics in heart failure and coronary vasoconstriction in coronary artery disease (CAD).
- ET-1 elevates blood pressure and induces hypertrophy, counteracting nitric oxide's (NO) beneficial effects.
Purpose of the Study:
- To review clinical trials on endothelin receptor antagonists.
- To assess the efficacy of these antagonists in cardiovascular conditions.
Main Methods:
- Review of completed and ongoing clinical trials.
- Focus on patient populations with heart failure, CAD, arterial hypertension, and pulmonary hypertension.
Main Results:
- ET-1's role as a prognostic marker in various cardiovascular diseases.
- The association between ET system activation and negative hemodynamic outcomes.
- ET-1's hypertensive and hypertrophic effects versus NO's vasodilating properties.
Conclusions:
- Endothelin receptor antagonists are being investigated for cardiovascular conditions.
- Further research is ongoing to evaluate their therapeutic potential.
Abstract:
Endothelin-1 (ET-1) is enhanced and has been demonstrated to be a prognostic marker in patients with advanced stages of heart failure, acute ischaemic syndromes, myocardial infarction and pulmonary hypertension. Activation of the endothelin (ET) system is associated with adverse haemodynamic consequences in patients with congestive heart failure and results in coronary vasoconstriction in patients with coronary artery disease (CAD). Moreover, ET-1 raises blood pressure, induces vascular and myocardial hypertrophy and acts as the natural counterpart of nitric oxide (NO), which exerts vasodilating, antithrombotic and antiproliferative effects. This article reviews recently completed and ongoing clinical trials examining the effects of ET receptor antagonists in patients with heart failure, CAD, arterial hypertension and pulmonary hypertension.