The global epidemic of diabetes is of significant concern. Diabetes associated vascular disease signifies the principal cause of morbidity and mortality in diabetic patients. It is also the most rapidly increasing risk factor for cognitive impairment, a silent disease that causes loss of creativity, productivity, and quality of life. Small vessel disease in the cerebral vasculature plays a major role in the pathogenesis of cognitive impairment in diabetes. Endothelin system, including endothelin-1 (ET-1) and the receptors (ET(A) and ET(B)), is a likely candidate that may be involved in many aspects of the diabetes cerebrovascular disease. In this review, we took a brain-centric approach and discussed the role of the ET system in cerebrovascular and cognitive dysfunction in diabetes.

• MeSH
• antagonisté endotelinového receptoru A aplikace a dávkování   metabolismus   MeSH
• antagonisté endotelinového receptoru B aplikace a dávkování   metabolismus   MeSH
• endoteliny agonisté   antagonisté a inhibitory   metabolismus   MeSH
• komplikace diabetu farmakoterapie   metabolismus   MeSH
• lidé MeSH
• mozek účinky léků   metabolismus   MeSH
• mozkový krevní oběh účinky léků   fyziologie   MeSH
• receptor endotelinu A metabolismus   MeSH
• receptor endotelinu B metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Pulmonary arterial hypertension (PAH) leads to reduced health-related quality of life (HRQoL). The objectives of this analysis were to evaluate the effect of macitentan on HRQoL in patients with PAH in the Study with an Endothelin Receptor Antagonist in Pulmonary Arterial Hypertension to Improve Clinical Outcome (SERAPHIN) study. The association between baseline HRQoL and long-term outcomes was also investigated. METHODS: Patients were randomized to placebo, macitentan 3 mg, or macitentan 10 mg once daily. Patients aged 14 years or older completed the 36-Item Short Form Survey (SF-36) at baseline, at month 6 and month 12, and at the end of treatment (EOT). The absolute change from baseline to month 6 in SF-36 scores was calculated. The time to a clinically meaningful deterioration in the SF-36 physical component summary and mental component summary (PCS and MCS) scores and associations between baseline PCS/MCS scores and time to morbidity/mortality events were also assessed. RESULTS: At month 6, macitentan 10 mg significantly improved seven of eight SF-36 domains and the PCS and MCS scores vs placebo. Macitentan 10 mg significantly reduced the risk of a three-point or greater deterioration in PCS (hazard ratio [HR], 0.60; 95% CI, 0.47-0.76; P < .0001) and MCS scores (HR, 0.76; 95% CI, 0.61-0.95; P = .0173) until EOT vs placebo. Patients with a baseline PCS score greater than the median baseline value had a significantly reduced risk of morbidity/mortality compared with patients with a PCS score less than the median; a similar result was observed for the MCS score. CONCLUSIONS: Macitentan significantly improved HRQoL in patients with PAH compared with placebo and significantly reduced the risk of a clinically meaningful HRQoL deterioration. An association between better baseline HRQoL and improved long-term outcomes was shown. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00660179; URL: clinicaltrials.gov.

• MeSH
• antagonisté endotelinového receptoru B aplikace a dávkování   škodlivé účinky   MeSH
• dospělí MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• monitorování léčiv metody   MeSH
• plicní hypertenze * diagnóza   farmakoterapie   patofyziologie   psychologie   MeSH
• posouzení stavu pacienta MeSH
• pyrimidiny * aplikace a dávkování   škodlivé účinky   MeSH
• sulfonamidy * aplikace a dávkování   škodlivé účinky   MeSH
• výsledek terapie MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

• MeSH
• antagonisté endotelinového receptoru A * aplikace a dávkování   farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• antagonisté endotelinového receptoru B * aplikace a dávkování   farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• dvojitá slepá metoda MeSH
• hospitalizace * MeSH
• lidé MeSH
• longitudinální studie MeSH
• pacienti hospitalizovaní MeSH
• plicní hypertenze * farmakoterapie   MeSH
• randomizované kontrolované studie jako téma MeSH
• registrace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• multicentrická studie MeSH