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May 27, 2004Expert Opinion on Therapeutic Targets14 citations

The endothelin system and its role in acute myocardial infarction

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SDSheila A Doggrell

Key Result

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.

Structured PICO

Does ET(A) receptor blockade reduce infarct size and ventricular arrhythmias in acute myocardial infarction?

P
Population
Animal models of acute myocardial infarction (rat, rabbit) and humans with AMI
I
Intervention
ET(A) receptor blockade and endothelin-converting enzyme blockade (SM-19712)
O
Outcome
Infarct size and ventricular arrhythmiassurrogate

Preclinical evidence suggests ET(A) receptor blockade reduces infarct size and arrhythmias in AMI, providing a rationale for human trials.

Abstract

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.

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Cite This Study

Sheila A Doggrell (2004) 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.

synapsesocial.com/papers/6a0a57aefdd00ab7863dca67https://doi.org/10.1517/14728222.8.3.191
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Intravenous Endothelin on Hemodynamics and Cardiac Contractility in Conscious Milan Normotensive Rats1991 · 21 citations
  2. 2Intrapericardial infusion of endothelin-1 induces ventricular arrhythmias in dogs1998 · 33 citations
  3. 3Plasma levels and vascular effects of endothelin and big endothelin in patients with stable and unstable angina pectoris undergoing coronary bypass grafting2002 · 7 citations
  4. 4Comparison of Circulating Endothelin-1 and Big Endothelin-1 Levels in Unstable Versus Stable Angina Pectoris1998 · 9 citations
  5. 5Protective effects of non-peptide endothelin receptor antagonist bosentan on myocardial ischaemic and reperfusion injury in the pig1995 · 39 citations