{"id":"ab0f76bdf30e","type":"article","url":"https://hartvaat.nl/2017/04/14/macitentan-en-hemodynamiek-bij-pah-seraphin-hemodynamische-substudie/","title":"Macitentan en hemodynamiek bij PAH: SERAPHIN hemodynamische substudie","title_en":"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.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog"],"tags":["bloeddrukbehandeling"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehx025","source_url":"https://doi.org/10.1093/eurheartj/ehx025","authors":["Nazzareno Galiè","Pavel Jansa","Tomás Pulido","Richard N Channick","Marion Delcroix","Hossein-Ardeschir Ghofrani","Franck-Olivier Le Brun","Sanjay Mehta","Loïc Perchenet","Lewis J Rubin","B K S Sastry","Gérald Simonneau","Olivier Sitbon","Rogério Souza","Adam Torbicki"],"significance":6,"published":"2017-04-14","source_date":"2017-04-14","image":"","kennis":[],"congress":"","summary_en":"This SERAPHIN hemodynamic substudy characterized the effects of macitentan on pulmonary hemodynamics and NT-proBNP in PAH, providing invasive assessment of the dual endothelin receptor antagonist's vascular effects.","created":"2026-07-03T10:26:39Z","updated":"2026-07-03T18:38:33Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Hemodynamische substudie van SERAPHIN die het effect van macitentan op hemodynamische parameters en NT-proBNP bij pulmonaal arteriële hypertensie onderzocht.","abstract_original":"AIMS: The effect of macitentan on haemodynamic parameters and NT-proBNP levels was evaluated in pulmonary arterial hypertension (PAH) patients in the SERAPHIN study. Association between these parameters and disease progression, assessed by the primary endpoint (time to first morbidity/mortality event), was explored. METHODS AND RESULTS: Of the 742 randomized patients, 187 with right heart catheterization at baseline and month 6 participated in a haemodynamic sub-study. Prespecified endpoints included change from baseline to month 6 in cardiac index (CI), right atrial pressure (RAP), mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), mixed-venous oxygen saturation, and NT-proBNP. Exploratory analyses examined associations between CI, RAP, and NT-proBNP and disease progression using the Kaplan-Meier method and Cox regression models. Macitentan improved CI, RAP, mPAP, PVR and NT-proBNP vs. placebo at month 6. Absolute levels of CI, RAP and NT-proBNP at baseline and month 6, but not their changes, were associated with morbidity/mortality events. Patients with CI > 2.5 L/min/m2, RAP < 8 mmHg, or NT-proBNP < 750 fmol/ml at month 6 had a lower risk of morbidity/mortality than those not meeting these thresholds (HR 0.49, 95% CL 0.28-0.86; HR 0.72, 95% CL 0.42-1.22; and HR 0.22, 95% CL 0.15-0.33, respectively). CONCLUSIONS: For all treatment groups, baseline and month 6 values of CI, RAP, and NT-proBNP, but not their changes, were associated with morbidity/mortality events, confirming their relevance in predicting disease progression in patients with PAH. By improving those parameters, macitentan increased the likelihood of reaching threshold values associated with lower risk of morbidity/mortality."}