Endothelin-1 may be key in mediating ischemia-reperfusion injury in patients with diabetics and use of endothelin receptor antagonists might be a novel approach to improving resistance of the diabetic heart to cardioplegic arrest and reperfusion.
These suggestions are from a pair of Canadian studies by doctors from Toronto General Hospital, University of Toronto, Toronto, Ontario, and Foothills Hospital, University of Calgary, Calgary, Alberta. The two studies were done against a backdrop of accumulating evidence that diabetic patients face increased risk of ischemic events and low output syndrome, and may mount an inordinate response to ischemia and reperfusion. Hyperglycemia is a potent stimulus for endothelin-1 production. Thus, increased production, action, or both, of endothelin-1 in these patients could prove to be an important mediator of endothelial dysfunction.
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