Endothelin-1 levels and cardiovascular events.

Circulating plasma levels of endothelin-1 and related peptides generated during the synthesis of endothelin-1 from its precursor molecule pre-proendothelin-1 have been widely studied as potential risk markers for cardiovascular events. The associations of endothelin-1 with aging, blood pressure, lung function, and chronic kidney disease have been described, as have relations between endothelin-1 levels and evidence of cardiac remodeling, including increased left atrial diameter and increased left ventricular mass. Endothelin-1 has been studied as a predictor of and prognostic marker in coronary artery disease, myocardial infarction, and heart failure. The relationship of endothelin-1 levels to mortality in the general population has also been explored. This review examines the current state of knowledge of circulating endothelin-1 levels as they relate to cardiovascular events and prognosis, and explores future directions for research, including using endothelin-1 or related peptide levels to guide personalized treatment regimens and to select patients for primary prevention strategies.