Juraj Hrnčiar, Mária Hrnčiarová
Endothelin-1 is a potent 21-aminoacid vasoconstricted peptide produced by endothelial cells of the cell wall and also by bronchi, gastrointestinal tract and urinary tract. It biological effect after bound on ET-A and ET-B1+B2-receptors induces strong vasoconstriction, pro-inflammatory, mitogenic and proliferatory effect, formation of free radicals and thrombocytes activation. With these mechanisms together with further risk factors of atherothrombogenesis participates on etiopathogenesis of a number of cardiovascular diseases, e.g, primary pulmonary hypertension, systemic arterial hypertension, all forms of vasospastic angina pectoris, fibrosis and calcification of aortal valves as well as on „no reflow“ phenomenon after percutaneous coronary intervention in acute myocardial infarction. Blockers ET-1 receptors, e.g. dual blocker A- and B-receptors bosentan and others, have been currently used in clinical practice only in treatment of the primary pulmonary hypertension. So far the relevant placebo controlled studies have not been reported that might assess costs, benefits and risks of the treatment in other indications than the primary pulmonary hypertension.