Endothelin and vasoactive peptides: new cardiovascular mediators.

A newly discovered family of vasoactive peptides, endothelins, have strong inotropic and chronotropic effects on the myocardium. Recent studies suggest a possible role for endothelin in pathophysiological states. The ability of these peptides to stimulate mitogenesis in smooth muscle and fibroblasts, coupled with their contribution to the regulation of gene expression and secretion of other neurohumoral mediators, raises the possibility that endothelins may contribute to the development of heart disease. Elevated levels of circulating endothelin have been found in the setting of elevated peak systolic pressure, pulmonary hypertension myocardial infarction, and congestive heart failure. This paper discusses the potential role of endothelin as a regional mediator of pathophysiological states.