F. Duru et al., Endothelin and cardiac arrhythmias: do endothelin antagonists have a therapeutic potential as antiarrhythmic drugs?, CARDIO RES, 49(2), 2001, pp. 272-280
Citations number
88
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Endothelin-1 (ET-1). the predominant isoform of the ET peptide family and a
potent vasoconstrictor, has been shown to aggravate ischemia-induced ventr
icular arrhythmias. However, there is also evidence that ET-1 may have a di
rect arrhythmogenic action that is not solely attributable to myocardial is
chemia. Proposed mechanisms for the arrhythmogenic effects of ET-1 are prol
ongation or increased dispersion of monophasic action potential duration, Q
T prolongation, development of early afterdepolarizations, acidosis, and au
gmentation of cellular injury. As for an ionic basis for the observed elect
rophysiologic effects, ET-induced Ca2+ release from intracellular stores, g
eneration of inositol triphosphate, inhibition of delayed rectifier K+ curr
ent, and stimulation of the Na+/H+ exchanger may be involved. Recently, som
e studies have shown that ET receptor antagonists, which promise to be powe
rful tools in cardiovascular medicine, may also demonstrate antiarrhythmic
properties. This review describes the current state of knowledge on the int
eractions between the ET system and cardiac arrhythmias, and discusses the
therapeutic potential of ET antagonists as antiarrhythmic drugs. (C) 2001 E
lsevier Science E.V. All rights reserved.