The guidelines for the diagnosis and treatment of hypertension recommend starting oral drug combination therapy for patients with cardiac function class II to III.[20] The combination therapy is becoming more and more important for the treatment of pulmonary hypertension after children with congenital heart disease. were randomly divided into 1 of 2 treatment regimens: 1. bosentan combined with vardenafil oral group and 2. vardenafil oral group. Patients, doctors, nurses, and data collection assistants were blinded to group allocation. Observation indicators include: oxyhemoglobin saturation (SpO2), 6-min Walking Test Distance (6 MWTD), systolic pulmonary artery pressure, mean pulmonary artery pressure, Borg score, NYHAFC score, etc. Data were analyzed using the statistical software package SPSS version 25.0 (Chicago, IL). Discussion: This study will evaluate the effectiveness and safety of bosentan combined with vardenafil in the treatment of pulmonary hypertension after congenital heart disease in children. The results of this experiment will provide a clinical basis for the use of bosentan combined with vardenafil to treat pulmonary hypertension after congenital heart disease in children. Ethics and dissemination: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF Registration number: DOI 10.17605/OSF.IO/962BT. value of .05 was considered statistically significant. 3.?Discussion Pulmonary hypertension is one of the common complications after congenital heart disease, and it is also an important risk factor for death from right heart failure.[11] With continuous research on the pathogenesis of pulmonary hypertension, it has been found that vasoconstriction, cell proliferation, inflammation, fibrosis, and thrombosis are all related to pulmonary vascular remodeling, while thromboxane, exhaled SC79 Mouse monoclonal to Calreticulin nitric oxide (eNO), and endothelin-1 (ET-1) and prostaglandin and other vasoactive mediators play an important role in it.[12,13] Therefore, how to effectively reduce the patient’s pulmonary vascular resistance and contain or reverse pulmonary vascular disease is of great significance for improving the survival rate of patients and improving the quality of life. Endothelin (ET) is an active substance with the strongest vasoconstrictor effect. The main place for its production and removal is lung tissue, which is one of the important factors that cause pulmonary hypertension. SC79 Bosentan tablets are competitive antagonists of endothelin ETA and ETB receptors. They can compete to antagonize human vascular wall ET-1 receptors, inhibit vasoconstriction and promote cell proliferation,[14] and can reduce lung and systemic vascular resistance, increase cardiac output without increasing heart rate.[15] Vardenafil is another new PDE-5 inhibitor after sildenafil, which can significantly reduce arterial pressure (PA) and venous pressure at the same time.[16] In addition to inhibiting PDE-5 and passing In addition to the nitric oxide-cyclic guanosine monophosphate(NO-cGMP) dependent mechanism that causes pulmonary artery relaxation, it can also activate some mechanisms that do not depend on NO-cGMP: nitric oxide-cyclic guanosine monophosphate, that is, induce pulmonary vasodilation by inhibiting the entry of extracellular Ca2+.[17,18] Some studies have pointed out that bosentan combined with vardenafil or sildenafil is better than monotherapy in the treatment of pulmonary hypertension after congenital heart disease in children,[7,19] in 2015 the Western Society of SC79 Cardiology (ESC) pulmonary artery. The guidelines for the analysis and treatment of hypertension recommend starting oral drug combination therapy for individuals with cardiac function class II to III.[20] The combination therapy is becoming more and more important for the treatment of pulmonary hypertension after children with congenital heart disease. This study will be evaluated the effect of bosentan combined with vardena on the treatment of pulmonary hypertension after nonchildren’s congenital heart disease. This study also has the following limitations: Since this is a singlecenter randomized controlled study, the included human population may be regionalized, and the results may be biased; factors such as SC79 the age of the individuals included in the study may have an impact within the results. Author contributions Data curation: Chao Gao and Junting Liu. Investigation: Junting Liu and Runhan Zhang. Resources: Manting Zhao. Funding acquisition: Yongli Wu. Software: Runhan Zhang. Supervision: Yongli Wu. Writing.