文章Vachiéry, Jean-Luc %A Delcroix, Marion %A Al-Hiti, Hikmet %A Efficace, Michela Hutyra, Martin %A Lack, Gabriela %A Papadakis, Kelly %A Rubin，刘易斯J . % T Macitentan肺动脉高压由于左心室功能障碍2018% % D J R 10.1183/13993003.01886 -2017%欧洲呼吸杂志% P 1701886 % V 51% N 2% X MELODY-1研究评估Macitentan肺动脉高压,因为左心脏病患者(PH-LHD)结合后和pre-capillary PH.63PH-LHD和舒张压梯度≥7 mmHg和肺血管阻力(PVR) >3WU的患者被随机分为马西坦10 mg (n=31)或安慰剂(n=32)，为期12周。主要终点评估了纽约心脏协会功能分级从基线到治疗结束的显著液体潴留(由于液体超载或肠外利尿剂给药导致体重增加≥5%或≥5 kg)或恶化的复合因素。探索终点包括第12周n端脑利钠肽前体(NT-proBNP)和血流动力学的变化。7例马吉坦治疗组和4例安慰剂治疗组患者出现明显的液体潴留/功能等级恶化;治疗差异10.08% (95% CI−15.07-33.26;p = 0.34)。在第一个月，由液体保留成分驱动的差异是明显的。在第12周，与安慰剂相比，macitentan组的PVR、平均右房压或肺动脉楔压没有变化; a non-significant increase in cardiac index (treatment effect 0.4 (95% CI 0.1–0.7) L·min−1·m−2) and decrease in NT-proBNP (0.77 (0.55–1.08)) was observed. Adverse events and serious adverse events were numerically more frequent with macitentan versus placebo.Macitentan-treated patients were quantitatively more likely to experience significant fluid retention versus placebo. Macitentan resulted in no significant changes in any exploratory end-points.In combined post- and pre-capillary PH patients, macitentan was associated with increased incidence of significant fluid retention versus placebo http://ow.ly/leop30hBkQm %U //www.qdcxjkg.com/content/erj/51/2/1701886.full.pdf