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Антагонисты эндотелиновых рецепторов в лечении легочной артериальной гипертензии: рациональный выбор специфической терапии - Журнал Системные Гипертензии Том 15, №1
Антагонисты эндотелиновых рецепторов в лечении легочной артериальной гипертензии: рациональный выбор специфической терапии
Кароли Н.А., Сажнова С.И., Ребров А.П. Антагонисты эндотелиновых рецепторов в лечении легочной артериальной гипертензии: рациональный выбор специфической терапии. Системные гипертензии. 2018; 15 (1): 45–50. DOI: 10.26442/2075-082X_15.1.45-50
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Аннотация
Легочная гипертензия характеризуется стойким повышением легочного сосудистого сопротивления, приводящим к прогрессивному нарастанию правожелудочковой недостаточности и смерти пациентов. В основе развития легочной гипертензии лежат структурные изменения артерий и артериол малого круга кровообращения вследствие дисфункции эндотелия. Эндотелин-1 – основной патогенетический медиатор легочной артериальной гипертензии и потенциальная мишень для терапевтического воздействия. Эффективность антагонистов рецепторов эндотелина доказана в многочисленных доклинических и клинических исследованиях. Несмотря на различия в активности по отношению к разным рецепторам, эффективность двойных и селективных антагонистов рецепторов эндотелина у больных легочной артериальной гипертензией сравнима. Бозентан – наиболее широко применяющийся легочный вазодилататор, улучшает переносимость физических нагрузок, снижает темпы прогрессирования заболевания. Более современные антагонисты рецепторов эндотелина – амбризентан и мацитентан – обладают преимуществами, связанными не только с их эффективностью, но и значительно лучшим профилем безопасности.
Ключевые слова: легочная артериальная гипертензия, антагонисты рецепторов эндотелина, бозентан, амбризентан, мацитентан.
Key words: pulmonary arterial hypertension, endothelin receptor antagonists, bosentan, ambrisentan, macitentan.
Ключевые слова: легочная артериальная гипертензия, антагонисты рецепторов эндотелина, бозентан, амбризентан, мацитентан.
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Key words: pulmonary arterial hypertension, endothelin receptor antagonists, bosentan, ambrisentan, macitentan.
Полный текст
Список литературы
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26. Iglarz M, Binkert C, Morrison K et al. Pharmacology of macitentan, an orally active tissue-targeting dual endothelin receptor antagonist. J Pharmacol Exp Ther 2008; 327: 736–45.
27. Rahaghi FF, Alnuaimat HM, Awdish RLA et al. Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document. Pulm Circ 2017; 7 (3): 702–11. DOI: 10.1177/2045893217721695
28. Galiè N, Jansa P, Pulido T et al. SERAPHIN haemodynamic substudy: the effect of the dual endothelin receptor antagonist macitentan on haemodynamic parameters and NT-proBNP levels and their association with disease progression in patients with pulmonary arterial hypertension. Eur Heart J 2017; 38 (15): 1147–55. DOI: 10.1093/eurheartj/ehx025
29. Duo-Ji MM, Long ZW. Comparative efficacy and acceptability of endothelin receptor antagonists for pulmonary arterial hypertension: A network meta-analysis. Int J Cardiol 2017; 234: 90–8. DOI: 10.1016/j.ijcard.2016.12.092
30. Jansa P, Pulido T. Macitentan in Pulmonary Arterial Hypertension: A Focus on Combination Therapy in the SERAPHIN Trial. Am J Cardiovasc Drugs 2018; 18 (1): 1–11. DOI: 10.1007/s40256-017-0260-1
31. Lajoie AC, Guay CA, Lega JC et al. Trial Duration and Risk Reduction in Combination Therapy Trials for Pulmonary Arterial Hypertension: A Systematic Review. Chest 2017. pii: S0012-3692(17)33125-2. DOI: 10.1016/j.chest.2017.11.014 [Epub ahead of print]
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33. Gao XF, Zhang JJ, Jiang XM et al. Targeted drugs for pulmonary arterial hypertension: a network meta-analysis of 32 randomized clinical trials. Patient Prefer Adherence 2017; 11: 871–85. DOI: 10.2147/PPA.S133288
34. Vizza CD, Jansa P, Teal S et al. Sildenafil dosed concomitantly with bosentan for adult pulmonary arterial hypertension in a randomized controlled trial. BMC Cardiovasc Disord 2017; 17 (1): 239. DOI: 10.1186/s12872-017-0674-3
35. Гайсин И.Р., Рычкова Л.В., Газимзянова А.С. и др. Эффективность мультидисциплинарной системы оказания помощи при легочной гипертензии. Кардиоваск. терапия и профилактика. 2017; 16 (1): 82–90. / Gaysin I.R., Rychkova L.V., Gazimzyanova A.S. i dr. Effektivnost' mul'tidistsiplinarnoy sistemy okazaniya pomoshchi pri legochnoy gipertenzii. Kardiovask. terapiya i profilaktika. 2017; 16 (1): 82–90. [in Russian]
36. Ilja M Blok, Annelieke CMJ, van Riel еt al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
2. Humbert M, Souza R, Galie N et al. Pulmonary arterial hypertension: bridging the present to the future. Eur Respir Rev 2012; 21 (126): 267–70.
3. Galie N, Rubin LJ et al. Pulmonary Arterial Hypertension: epidemiology, pathobiology, assessment, and therapy. J Am Coll Cardiology 2004; 12: 5–12.
4. Barst RJ, McGoon M, Torbicki A et al. Diagnosis and differential assessment of pulmonary artrerial hypertension. J Am Coll Cardiol 2004; 43 (Suppl. 12): 40–7.
5. McLaughlin VV, McGoon MD. Pulmonary arterial hypertension. Circulation 2006; 114: 1417–31.
6. Galie N, Humbert M, Vachiery JL et al. 2015 ECS/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2016; 37: 67–119.
7. Chazova I.E., Avdeev S.N., Tsareva N.A. i dr. Klinicheskie rekomendatsii po diagnostike i lecheniyu legochnoy gipertonii. Terapevt. arkh. 2014; 9: 4–23. [in Russian]
8. Studer SM, Kingman M, Calo L et al. Considerations for optimal management of patients with pulmonary arterial hypertension: a multi-stakeholder roundtable discussion. Am J Manag Care 2017; 23 (Suppl. 6): S95–S104.
9. Kovacs G, Avian A, Olschewski A, Olschewski H. Zero reference level for right heart catheterization. Eur Respir J 2013; 42: 1586–94.
10. Hoeper MM, Huscher D, Ghofrani HA et al. Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the COMPERA registry. Int J Cardiol 2013; 168: 871–80.
11. Humbert M, Sitbon O, Yaici A et al. Survival in incident and prevalent cohort of patients with pulmonary arterial hypertension. Eur Respir J 2010; 36: 549–55.
12. Nickel N, Golpon H, Greer M et al. The prognostic impact of follow-up assessments in patients with idiopathic pulmonary arterial hypertension. Eur Respir J 2012; 39: 589–96.
13. Callahan WE, Amorosino CS. Endothelial dysfunction in pulmonary hypertension. N Engl J Med 1992; 327: 177–19.
14. Morrell N, Adnot S, Archer S et al. Cellular and molecular basis of pulmonary arterial hypertension. J Am Coll Cardiol 2009; 54 (Suppl. 1): 20–31.
15. Benza RL, Miller DP, Gomberg-Maitland M et al. Predicting survivalin pulmonary arterial hypertension: insights from the Registryto Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL). Circulation 2010; 122: 164–72.
16. Simonneau G, Gatzolis G, Adatia I et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62 (Suppl. 25): 35–41.
17. Karoli N.A., Rebrov A.P. Legochnaya gipertoniya pri sistemnykh zabolevaniyakh soedi-nitel'noy tkani. Terapevt. arkh. 2005; 77 (12): 83–8. [in Russian]
18. Karoli N.A., Rebrov AP. Legochnaya gipertenziya u bol'nykh sistemnoy sklerodermiey. Кlin. meditsina. 2016; 94 (12): 918–23. [in Russian]
19. Moiseeva O.M., Rudakova A.V. Farmakoekonomicheskie aspekty primeneniya matsitentana pri terapii legochnoy arterial'noy gipertonii. Terapevt. arkh. 2017; 3: 72–7. [in Russian]
20. Shostak N.A., Klimenko A.A., Demidova N.A. The role of endothelin-1 receptor antagonist bosentan in the treatment of pulmonary hypertension. Consilium Medicum. 2017; 19 (10): 113–7. [in Russian]
21. Martynyuk T.V., Nakonechnikov S.N., Chazova I.E. Optimizatsiya spetsificheskoy terapii legochnoy arterial'noy gipertenzii: vozmozhnosti primeneniya antagonistov retseptorov endotelina. Evraziyskiy kardiol. zhurn. 2017; 2: 1–8. [in Russian]
22. Ataya A, Cope J, Alnuaimat H. A Review of Targeted Pulmonary Arterial Hypertension-Specific Pharmacotherapy. J Clin Med 2016; 5 (12). pii: E114. Review.
23. Martynyuk T.V, Arkhipova O.A., Kobal' E.A. et al. Use of the nonselective endothelin receptor antagonist bosentan in patients with idiopathic pulmonary hypertension: the first Russian experience and vision of the future. Systemic Hypertension. 2011; 8 (4): 51–7. [in Russian]
24. Taichman DB, Ornelas J, Chung L et al. Pharmacologic therapy for Pulmonary Arterial Hypertension in Adults CHEST Guideline and Expert Panel Report. CHEST 2014; 146 (2): 449–75.
25. Rivera-Lebron BN, Risbano MG. Ambrisentan: a review of its use in pulmonary arterial hypertension. Ther Adv Respir Dis 2017; 11 (6): 233–44. DOI: 10.1177/1753465817696040
26. Iglarz M, Binkert C, Morrison K et al. Pharmacology of macitentan, an orally active tissue-targeting dual endothelin receptor antagonist. J Pharmacol Exp Ther 2008; 327: 736–45.
27. Rahaghi FF, Alnuaimat HM, Awdish RLA et al. Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document. Pulm Circ 2017; 7 (3): 702–11. DOI: 10.1177/2045893217721695
28. Galiè N, Jansa P, Pulido T et al. SERAPHIN haemodynamic substudy: the effect of the dual endothelin receptor antagonist macitentan on haemodynamic parameters and NT-proBNP levels and their association with disease progression in patients with pulmonary arterial hypertension. Eur Heart J 2017; 38 (15): 1147–55. DOI: 10.1093/eurheartj/ehx025
29. Duo-Ji MM, Long ZW. Comparative efficacy and acceptability of endothelin receptor antagonists for pulmonary arterial hypertension: A network meta-analysis. Int J Cardiol 2017; 234: 90–8. DOI: 10.1016/j.ijcard.2016.12.092
30. Jansa P, Pulido T. Macitentan in Pulmonary Arterial Hypertension: A Focus on Combination Therapy in the SERAPHIN Trial. Am J Cardiovasc Drugs 2018; 18 (1): 1–11. DOI: 10.1007/s40256-017-0260-1
31. Lajoie AC, Guay CA, Lega JC et al. Trial Duration and Risk Reduction in Combination Therapy Trials for Pulmonary Arterial Hypertension: A Systematic Review. Chest 2017. pii: S0012-3692(17)33125-2. DOI: 10.1016/j.chest.2017.11.014 [Epub ahead of print]
32. Lajoie AC, Bonnet S, Provencher S. Combination therapy in pulmonary arterial hypertension: recent accomplishments and future challenges. Pulm Circ 2017; 7 (2): 312–25. DOI: 10.1177/2045893217710639
33. Gao XF, Zhang JJ, Jiang XM et al. Targeted drugs for pulmonary arterial hypertension: a network meta-analysis of 32 randomized clinical trials. Patient Prefer Adherence 2017; 11: 871–85. DOI: 10.2147/PPA.S133288
34. Vizza CD, Jansa P, Teal S et al. Sildenafil dosed concomitantly with bosentan for adult pulmonary arterial hypertension in a randomized controlled trial. BMC Cardiovasc Disord 2017; 17 (1): 239. DOI: 10.1186/s12872-017-0674-3
35. Gaysin I.R., Rychkova L.V., Gazimzyanova A.S. i dr. Effektivnost' mul'tidistsiplinarnoy sistemy okazaniya pomoshchi pri legochnoy gipertenzii. Kardiovask. terapiya i profilaktika. 2017; 16 (1): 82–90. [in Russian]
36. Ilja M Blok, Annelieke CMJ, van Riel еt al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
2. Humbert M, Souza R, Galie N et al. Pulmonary arterial hypertension: bridging the present to the future. Eur Respir Rev 2012; 21 (126): 267–70.
3. Galie N, Rubin LJ et al. Pulmonary Arterial Hypertension: epidemiology, pathobiology, assessment, and therapy. J Am Coll Cardiology 2004; 12: 5–12.
4. Barst RJ, McGoon M, Torbicki A et al. Diagnosis and differential assessment of pulmonary artrerial hypertension. J Am Coll Cardiol 2004; 43 (Suppl. 12): 40–7.
5. McLaughlin VV, McGoon MD. Pulmonary arterial hypertension. Circulation 2006; 114: 1417–31.
6. Galie N, Humbert M, Vachiery JL et al. 2015 ECS/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2016; 37: 67–119.
7. Чазова И.Е., Авдеев С.Н., Царева Н.А. и др. Клинические рекомендации по диагностике и лечению легочной гипертонии. Терапевт. арх. 2014; 9: 4–23. / Chazova I.E., Avdeev S.N., Tsareva N.A. i dr. Klinicheskie rekomendatsii po diagnostike i lecheniyu legochnoy gipertonii. Terapevt. arkh. 2014; 9: 4–23. [in Russian]
8. Studer SM, Kingman M, Calo L et al. Considerations for optimal management of patients with pulmonary arterial hypertension: a multi-stakeholder roundtable discussion. Am J Manag Care 2017; 23 (Suppl. 6): S95–S104.
9. Kovacs G, Avian A, Olschewski A, Olschewski H. Zero reference level for right heart catheterization. Eur Respir J 2013; 42: 1586–94.
10. Hoeper MM, Huscher D, Ghofrani HA et al. Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the COMPERA registry. Int J Cardiol 2013; 168: 871–80.
11. Humbert M, Sitbon O, Yaici A et al. Survival in incident and prevalent cohort of patients with pulmonary arterial hypertension. Eur Respir J 2010; 36: 549–55.
12. Nickel N, Golpon H, Greer M et al. The prognostic impact of follow-up assessments in patients with idiopathic pulmonary arterial hypertension. Eur Respir J 2012; 39: 589–96.
13. Callahan WE, Amorosino CS. Endothelial dysfunction in pulmonary hypertension. N Engl J Med 1992; 327: 177–19.
14. Morrell N, Adnot S, Archer S et al. Cellular and molecular basis of pulmonary arterial hypertension. J Am Coll Cardiol 2009; 54 (Suppl. 1): 20–31.
15. Benza RL, Miller DP, Gomberg-Maitland M et al. Predicting survivalin pulmonary arterial hypertension: insights from the Registryto Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL). Circulation 2010; 122: 164–72.
16. Simonneau G, Gatzolis G, Adatia I et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62 (Suppl. 25): 35–41.
17. Кароли Н.А., Ребров А.П. Легочная гипертония при системных заболеваниях соединительной ткани. Терапевт. арх. 2005; 77 (12): 83–8. / Karoli N.A., Rebrov A.P. Legochnaya gipertoniya pri sistemnykh zabolevaniyakh soedi-nitel'noy tkani. Terapevt. arkh. 2005; 77 (12): 83–8. [in Russian]
18. Кароли Н.А., Ребров А.П. Легочная гипертензия у больных системной склеродермией. Клин. медицина. 2016; 94 (12): 918–23. / Karoli N.A., Rebrov AP. Legochnaya gipertenziya u bol'nykh sistemnoy sklerodermiey. Кlin. meditsina. 2016; 94 (12): 918–23. [in Russian]
19. Моисеева О.М., Рудакова А.В. Фармакоэкономические аспекты применения мацитентана при терапии легочной артериальной гипертонии. Терапевт. арх. 2017; 3: 72–7. / Moiseeva O.M., Rudakova A.V. Farmakoekonomicheskie aspekty primeneniya matsitentana pri terapii legochnoy arterial'noy gipertonii. Terapevt. arkh. 2017; 3: 72–7. [in Russian]
20. Шостак Н.А., Клименко А.А., Демидова Н.А. Роль антагониста рецепторов эндотелина-1 бозентана в лечении легочной гипертензии. Consilium Medicum. 2017; 19 (10): 113–7. / Shostak N.A., Klimenko A.A., Demidova N.A. The role of endothelin-1 receptor antagonist bosentan in the treatment of pulmonary hypertension. Consilium Medicum. 2017; 19 (10): 113–7. [in Russian]
21. Мартынюк Т.В., Наконечников С.Н., Чазова И.Е. Оптимизация специфической терапии легочной артериальной гипертензии: возможности применения антагонистов рецепторов эндотелина. Евразийский кардиол. журн. 2017; 2: 1–8. / Martynyuk T.V., Nakonechnikov S.N., Chazova I.E. Optimizatsiya spetsificheskoy terapii legochnoy arterial'noy gipertenzii: vozmozhnosti primeneniya antagonistov retseptorov endotelina. Evraziyskiy kardiol. zhurn. 2017; 2: 1–8. [in Russian]
22. Ataya A, Cope J, Alnuaimat H. A Review of Targeted Pulmonary Arterial Hypertension-Specific Pharmacotherapy. J Clin Med 2016; 5 (12). pii: E114. Review.
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27. Rahaghi FF, Alnuaimat HM, Awdish RLA et al. Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document. Pulm Circ 2017; 7 (3): 702–11. DOI: 10.1177/2045893217721695
28. Galiè N, Jansa P, Pulido T et al. SERAPHIN haemodynamic substudy: the effect of the dual endothelin receptor antagonist macitentan on haemodynamic parameters and NT-proBNP levels and their association with disease progression in patients with pulmonary arterial hypertension. Eur Heart J 2017; 38 (15): 1147–55. DOI: 10.1093/eurheartj/ehx025
29. Duo-Ji MM, Long ZW. Comparative efficacy and acceptability of endothelin receptor antagonists for pulmonary arterial hypertension: A network meta-analysis. Int J Cardiol 2017; 234: 90–8. DOI: 10.1016/j.ijcard.2016.12.092
30. Jansa P, Pulido T. Macitentan in Pulmonary Arterial Hypertension: A Focus on Combination Therapy in the SERAPHIN Trial. Am J Cardiovasc Drugs 2018; 18 (1): 1–11. DOI: 10.1007/s40256-017-0260-1
31. Lajoie AC, Guay CA, Lega JC et al. Trial Duration and Risk Reduction in Combination Therapy Trials for Pulmonary Arterial Hypertension: A Systematic Review. Chest 2017. pii: S0012-3692(17)33125-2. DOI: 10.1016/j.chest.2017.11.014 [Epub ahead of print]
32. Lajoie AC, Bonnet S, Provencher S. Combination therapy in pulmonary arterial hypertension: recent accomplishments and future challenges. Pulm Circ 2017; 7 (2): 312–25. DOI: 10.1177/2045893217710639
33. Gao XF, Zhang JJ, Jiang XM et al. Targeted drugs for pulmonary arterial hypertension: a network meta-analysis of 32 randomized clinical trials. Patient Prefer Adherence 2017; 11: 871–85. DOI: 10.2147/PPA.S133288
34. Vizza CD, Jansa P, Teal S et al. Sildenafil dosed concomitantly with bosentan for adult pulmonary arterial hypertension in a randomized controlled trial. BMC Cardiovasc Disord 2017; 17 (1): 239. DOI: 10.1186/s12872-017-0674-3
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36. Ilja M Blok, Annelieke CMJ, van Riel еt al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
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22. Ataya A, Cope J, Alnuaimat H. A Review of Targeted Pulmonary Arterial Hypertension-Specific Pharmacotherapy. J Clin Med 2016; 5 (12). pii: E114. Review.
23. Martynyuk T.V, Arkhipova O.A., Kobal' E.A. et al. Use of the nonselective endothelin receptor antagonist bosentan in patients with idiopathic pulmonary hypertension: the first Russian experience and vision of the future. Systemic Hypertension. 2011; 8 (4): 51–7. [in Russian]
24. Taichman DB, Ornelas J, Chung L et al. Pharmacologic therapy for Pulmonary Arterial Hypertension in Adults CHEST Guideline and Expert Panel Report. CHEST 2014; 146 (2): 449–75.
25. Rivera-Lebron BN, Risbano MG. Ambrisentan: a review of its use in pulmonary arterial hypertension. Ther Adv Respir Dis 2017; 11 (6): 233–44. DOI: 10.1177/1753465817696040
26. Iglarz M, Binkert C, Morrison K et al. Pharmacology of macitentan, an orally active tissue-targeting dual endothelin receptor antagonist. J Pharmacol Exp Ther 2008; 327: 736–45.
27. Rahaghi FF, Alnuaimat HM, Awdish RLA et al. Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document. Pulm Circ 2017; 7 (3): 702–11. DOI: 10.1177/2045893217721695
28. Galiè N, Jansa P, Pulido T et al. SERAPHIN haemodynamic substudy: the effect of the dual endothelin receptor antagonist macitentan on haemodynamic parameters and NT-proBNP levels and their association with disease progression in patients with pulmonary arterial hypertension. Eur Heart J 2017; 38 (15): 1147–55. DOI: 10.1093/eurheartj/ehx025
29. Duo-Ji MM, Long ZW. Comparative efficacy and acceptability of endothelin receptor antagonists for pulmonary arterial hypertension: A network meta-analysis. Int J Cardiol 2017; 234: 90–8. DOI: 10.1016/j.ijcard.2016.12.092
30. Jansa P, Pulido T. Macitentan in Pulmonary Arterial Hypertension: A Focus on Combination Therapy in the SERAPHIN Trial. Am J Cardiovasc Drugs 2018; 18 (1): 1–11. DOI: 10.1007/s40256-017-0260-1
31. Lajoie AC, Guay CA, Lega JC et al. Trial Duration and Risk Reduction in Combination Therapy Trials for Pulmonary Arterial Hypertension: A Systematic Review. Chest 2017. pii: S0012-3692(17)33125-2. DOI: 10.1016/j.chest.2017.11.014 [Epub ahead of print]
32. Lajoie AC, Bonnet S, Provencher S. Combination therapy in pulmonary arterial hypertension: recent accomplishments and future challenges. Pulm Circ 2017; 7 (2): 312–25. DOI: 10.1177/2045893217710639
33. Gao XF, Zhang JJ, Jiang XM et al. Targeted drugs for pulmonary arterial hypertension: a network meta-analysis of 32 randomized clinical trials. Patient Prefer Adherence 2017; 11: 871–85. DOI: 10.2147/PPA.S133288
34. Vizza CD, Jansa P, Teal S et al. Sildenafil dosed concomitantly with bosentan for adult pulmonary arterial hypertension in a randomized controlled trial. BMC Cardiovasc Disord 2017; 17 (1): 239. DOI: 10.1186/s12872-017-0674-3
35. Gaysin I.R., Rychkova L.V., Gazimzyanova A.S. i dr. Effektivnost' mul'tidistsiplinarnoy sistemy okazaniya pomoshchi pri legochnoy gipertenzii. Kardiovask. terapiya i profilaktika. 2017; 16 (1): 82–90. [in Russian]
36. Ilja M Blok, Annelieke CMJ, van Riel еt al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
Авторы
Н.А.Кароли, С.И.Сажнова, А.П.Ребров*
ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И.Разумовского» Минздрава России. 410012, Россия, Саратов, ул. Большая Казачья, д. 112
*andreyrebrov@yandex.ru
V.I.Razumovsky Saratov State Medical University of the Ministry of Health of the Russian Federation. 410012, Russian Federation, Saratov, ul. Bol'shaia Kazach'ia, d. 112
*andreyrebrov@yandex.ru
ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И.Разумовского» Минздрава России. 410012, Россия, Саратов, ул. Большая Казачья, д. 112
*andreyrebrov@yandex.ru
________________________________________________
V.I.Razumovsky Saratov State Medical University of the Ministry of Health of the Russian Federation. 410012, Russian Federation, Saratov, ul. Bol'shaia Kazach'ia, d. 112
*andreyrebrov@yandex.ru
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