<h6>Bosentan is a dual endothelin receptor antagonist with affinity for both ETA and ETB receptors. Bosentan decreases both pulmonary and systemic vascular resistance, resulting in increased cardiac output without increasing heart rate. The neurohormone endothelin is a potent vasoconstrictor with the ability to promote fibrosis, cell proliferation, and tissue remodeling. Endothelin concentrations in plasma and tissues are increased in a number of cardiovascular disorders, including pulmonary hypertension, suggesting a pathological role for endothelin in these diseases. In pulmonary arterial hypertension, endothelin plasma concentrations strongly correlate with poor prognosis .</h6>
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