Future research is needed to determine if combined inhibition of multiple cardiovascular systems using mixed ECE inhibitors is superior to selective inhibition.
Recent research has led to the discovery of potent selective or mixed endothelin-converting enzyme (ECE), ECE/neutral endopeptidase24.11 (NEP) and ECE/NEP24.11/angiotensin-converting enzyme (ACE) inhibitors. There is also increasing evidence, that the functions of the endothelin (ET), renin-angiotensin and NEP systems for the regulation of the cardiovascular homeostasis are connected by a complex regulation network. It will be the challenging task of future research with the newly available selective and mixed ECE-1 inhibitors to show whether the combined inhibition of more than one cardiovascular system is superior to selective inhibition.
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B M Löffler (2000) studied this question.
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