In line with previous observations in swine with type II PH secondary to myocardial infarction [25] and pulmonary vein stenosis [57], ETA + Bi produced a greater reduction in PVR in swine with DM + HC + CKD, suggesting that the balance between the vasoconstrictor and vasodilator pathways is shifted towards vasoconstriction in the DM + HC + CKD swine, and consistent with a withdrawal of endothelial ETB influence. This evidence concerns the gene EDNRB and myocardial infarction.