What is the role of endothelin receptor antagonists in the treatment of cor pulmonale?

Updated: Dec 15, 2017
  • Author: Derek Leong, MD; Chief Editor: Henry H Ooi, MD, MRCPI  more...
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Bosentan and macitentan are mixed endothelin-A and endothelin-B receptor antagonists, whereas ambrisentan is a selective endothelin-A receptor antagonist. Endothelins are peptides that act via vasoconstriction; thus, endotelin receptor antagonists indicated result in subsequent vasodilation. In clinical trials, bosentan improved exercise capacity, decreased rate of clinical deterioration, and improved hemodynamics. [28]

The endothelin receptor antagonists are indicated in idiopathic pulmonary artery hypertension as well as pulmonary hypertension secondary to connective tissue disorders (group I pulmonary hypertension). Common side effects include elevated liver function test findings.

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