ET(A) receptor blockade reduces infarct size and ventricular arrhythmias in animal models of acute myocardial infarction, suggesting it should be considered for clinical trials in humans.
Does ET(A) receptor blockade reduce infarct size and ventricular arrhythmias in acute myocardial infarction?
Preclinical evidence suggests ET(A) receptor blockade reduces infarct size and arrhythmias in AMI, providing a rationale for human trials.
Endothelin (ET)-1 is a potent coronary vasoconstrictor. On the heart, ET-1 is a potent positive inotrope and may be pro-arrhythmic. Plasma ET-1 levels are raised after acute myocardial infarction (AMI) and recanalisation in humans. This probably contributes to the coronary vasoconstriction that underlies the myocardial ischaemia and ventricular dysfunction at this time. During occlusion of the rat coronary artery, ventricular arrhythmias are reduced by ET(A) receptor blockade. Short-term ET(A) receptor blockade also reduces infarct size in animal models of AMI (coronary occlusion followed by reperfusion). Blockade of the endothelin-converting enzyme with SM-19712 reduced the infarct size in the rabbit model of AMI. ET(A) receptor blockade is associated with coronary artery dilation in humans. As there are indications that ET(A) receptor antagonists are protective in animal models of AMI, short-term ET(A) receptor blockade should be considered for trial in human AMI.
Sheila A Doggrell (Thu,) conducted a review in Acute myocardial infarction. ET(A) receptor blockade was evaluated. ET(A) receptor blockade reduces infarct size and ventricular arrhythmias in animal models of acute myocardial infarction, suggesting it should be considered for clinical trials in humans.
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