Worldwide experts in IE management, although the majority of them were involved and co-signed the guidelines, do not follow international consensus guidelines on the particular point of the use of antibiotics.
Endothelins are peptides with powerful vasoconstrictor and mitogenic properties. It has become evident that endothelins are involved in many regulatory mechanisms of the circulation in which they have a modulating role both in short and in long term. However, in many cases it remains unclear whether the alteration of the endothelin metabolism is a primary pathology or a secondary phenomenon. The synthesis of endothelin receptor antagonists and animal models with altered endothelin metabolism have opened a new era of endothelin research that will allow insight into the mechanisms of endothelin-action and eventually might lead to new therapeutic concepts. This review discusses the evidence both in favor and against pathogenic effects of endothelins in cardiovascular disease.
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