Key result
Endothelin-1 acts as a critical autocrine and paracrine regulator that acutely modulates cardiac contractility and chronically drives maladaptive hypertrophic remodeling in cardiovascular disease.
This review highlights the dual role of endothelin-1 in regulating normal cardiac contractility and driving pathological remodeling, emphasizing its importance in the pathophysiology of heart failure.
Hypothesis-generating for endothelin-1 targeting in heart failure; prospective trials needed before clinical adoption.
UNLABELLED: Endothelin-1 (ET-1) is a critical autocrine and paracrine regulator of cardiac physiology and pathology. Produced locally within the myocardium in response to diverse mechanical and neurohormonal stimuli, ET-1 acutely modulates cardiac contractility. During pathological cardiovascular conditions such as ischaemia, left ventricular hypertrophy and heart failure, myocyte expression and activity of the entire ET-1 system is enhanced, allowing the peptide to both initiate and maintain maladaptive cellular responses. Both the acute and chronic effects of ET-1 are dependent on the activation of intracellular signalling pathways, regulated by the inositol-trisphosphate and diacylglycerol produced upon activation of the ET(A) receptor. Subsequent stimulation of protein kinases C and D, calmodulin-dependent kinase II, calcineurin and MAPKs modifies the systolic calcium transient, myofibril function and the activity of transcription factors that coordinate cellular remodelling. The precise nature of the cellular response to ET-1 is governed by the timing, localization and context of such signals, allowing the peptide to regulate both cardiomyocyte physiology and instigate disease. LINKED ARTICLES: This article is part of a themed section on Endothelin. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.168.issue-1.
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Drawnel et al. (2012) conducted a review in Cardiac physiology and pathology. Endothelin-1 (ET-1) was evaluated. Endothelin-1 acts as a critical autocrine and paracrine regulator that acutely modulates cardiac contractility and chronically drives maladaptive hypertrophic remodeling in cardiovascular disease.
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