Emerging Role of the Urotensin II System in Cardiovascular Disease

Urotensin II is a potent 11-amino-acid vasoconstrictor peptide. The discovery of its endogenous receptor has led to renewed interest in its role in human cardiovascular physiology and pathophysiology. The cardiovascular actions of urotensin II are complex and include direct effects on the vasculature, systemic hemodynamic effects and effects on the myocardium, including actions on contractility, myocyte hypertrophy and extracellular matrix deposition. Plasma levels of urotensin have been found to be elevated in patients with chronic heart failure, diabetes mellitus and chronic renal disease. These elevations raise the possibility that urotensin II might be involved in the pathogenesis and/or progression of these disease states. Highly selective urotensin II antagonists have been developed, which should help to definitively clarify the role of urotensin II in these and other conditions.