TY - JOUR T1 - Macitentan治疗左心室功能不全所致肺动脉高血压JF -欧洲呼吸杂志JO - Eur Respir J DO - 10.1183/13993003.01886-2017 VL - 51 IS -2 SP - 1701886 AU - Vachiéry, Jean-Luc AU - Delcroix, Marion AU - Al-Hiti, Hikmet AU - efface, Michela AU - Hutyra, Martin AU - Lack, Gabriela AU - Papadakis, Kelly AU - Rubin，MELODY-1研究评估了macitentan对合并毛细血管扩张后和扩张前病变的左心疾病所致肺动脉高压(PH-LHD)的疗效。63例PH-LHD患者，舒张压梯度≥7 mmHg，肺血管阻力(PVR) >3WU患者被随机分到macitentan 10mg组(n=31)或安慰剂组(n=32)，持续12周。主要终点评估了显著的液体潴留(由于液体超载或肠外利尿剂给药，体重增加≥5%或≥5kg)或纽约心脏协会功能等级从基线到治疗结束恶化的综合指标。探索性终点包括第12周时n端脑利钠肽前体(NT-proBNP)和血流动力学的变化。7例接受西坦治疗的患者和4例接受安慰剂治疗的患者经历了明显的液体潴留/功能等级恶化;治疗差异，10.08% (95% CI−15.07-33.26;p = 0.34)。由液体滞留成分驱动的差异在第一个月内就很明显。第12周，与安慰剂组相比，莫西坦组PVR、平均右心房压或肺动脉楔形压无变化;心脏指数(治疗效果0.4 (95% CI 0.1-0.7) L·min - 1·m - 2)无显著升高，NT-proBNP(0.77(0.55-1.08)下降。 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 ER -