[Treatment with inhaled nitric oxide in patients with pulmonary embolism].

Inhaled NO therapy added to standard anticoagulation produced significantly greater reduction in systolic pulmonary artery pressure compared to anticoagulation alone by day 10.

• Patients with moderate-low-risk PE were randomized to experimental (n=30) or control (n=35) groups
• Experimental group received inhaled NO therapy with standard anticoagulant therapy; control group received only anticoagulants
• On the 10th day of the study, the experimental group showed 'significantly more pronounced decrease of systolic PAP' compared with the control group
• The study duration for primary outcome assessment was 10 days

Inhaled NO therapy resulted in significantly greater reduction in right heart sizes compared to anticoagulation alone by day 10.

• Right heart chamber dimensions were assessed echocardiographically
• The experimental group (n=30) showed 'significantly more pronounced decrease' of right heart sizes compared with the control group (n=35)
• This was measured at day 10 of the study
• Both groups received standard anticoagulant therapy as background treatment

Inhaled NO therapy was associated with statistically significant positive dynamics of vital signs including respiratory rate, heart rate, and blood pressure compared to control.

• Vital signs assessed included respiratory rate, heart rate, and arterial blood pressure
• Statistically significant improvements were observed in the experimental group versus control group
• Dyspnea assessed by mMRC scale also showed statistically significant positive dynamics in the experimental group
• Assessments were made on day 10 of the study

Inhaled NO therapy produced statistically significant improvement in arterial oxygen partial pressure compared to the control group.

• Arterial oxygen partial pressure (PaO2) was measured in both groups
• The experimental group (n=30) showed statistically significant positive dynamics compared to the control group (n=35)
• This finding was reported at day 10 of the study
• Improvement in oxygenation is consistent with reduction in pulmonary vasoconstriction and improved ventilation-perfusion matching

Inhaled NO therapy resulted in statistically significant improvements in nitrosative status markers including exhaled NO and saliva nitrite levels compared to control.

• Nitrosative status was assessed by measuring exhaled NO concentration and nitrite levels in saliva
• Both markers showed statistically significant positive dynamics in the experimental group versus control group by day 10
• These markers reflect endogenous NO bioavailability and nitric oxide pathway activity
• Changes in nitrosative status were considered evidence of the pharmacodynamic effect of inhaled NO therapy

Inhaled NO therapy produced statistically significant improvement in NT-proBNP levels compared to the control group.

• NT-proBNP (N-terminal pro-brain natriuretic peptide) was measured in blood serum as a marker of right ventricular stress
• The experimental group showed statistically significant positive dynamics in NT-proBNP compared with the control group
• NT-proBNP improvement reflects reduced right ventricular afterload and wall stress
• Assessment was performed on day 10 of the study

The study population consisted of 65 patients with moderate-low-risk pulmonary embolism randomized into two groups with differing baseline sex distributions.

• Experimental group: n=30, 27 men, 3 women, mean age 53.1 ± 16.8 years
• Control group: n=35, 21 men, 14 women, mean age 56.8 ± 14.1 years
• All patients had moderate-low-risk PE
• Randomization was performed to assign patients to experimental or control conditions

Pulmonary vasoconstriction resulting from neurohumoral response to acute pulmonary pressure increase makes a significant contribution to pulmonary artery pressure elevation in PE.

• PE is accompanied by both mechanical obstruction of the pulmonary vascular bed and pulmonary vasoconstriction
• Vasoconstriction is described as making 'a significant contribution to pulmonary artery pressure increase'
• Modern PE treatment is 'mainly directed at restoring perfusion, while treatment of pulmonary vasoconstriction is overlooked'
• NO is described as an endothelial mediator with vasorelaxing and moderate antiplatelet properties that can correct pulmonary vasoconstriction severity