Urotensin II: a cardiovascular and renal update

Purpose of review Urotensin II is a highly conserved undecapeptide which is well represented in the nervous system, heart and kidney. This review summarizes recent studies on cardiovascular and renal pathophysiology of urotensin II and clinical studies exploring the role of this peptide in cardiovascular and renal diseases. Recent findings Urotensin II was initially seen as a vasoconstrictor/cardiodepressant compound and implicated in myocardial and renal dysfunction. Emerging evidence in experimental models and in humans indicates that urotensin II may play a cardioprotective role in coronary heart disease and in chronic renal failure. Summary Administration of urotensin II produces a cardiodepressant effect in normal rats but exerts beneficial renal hemodynamic effects and preserves myocardial contractility in rats with chronic volume overload. Both urotensin II and urotensin-related peptide exhibit a myocardial protective property in an ischemia-reperfusion injury model in the isolated perfused rat heart. In patients with acute cardiac ischemia, circulating urotensin II is lower than normal and low plasma urotensin II signals a higher risk of adverse clinical events following myocardial infarction. Similarly, low urotensin II appears linked to death, cardiomyopathy and cardiovascular complications in patients with advanced renal insufficiency.