Objective:This study aims to investigate the effects of a novel hybrid compound CDDO -NO from bardoxolone methyl (CDDO-Me)and NO donor isosorbide 5-mononitrate on monocrotaline(MCT)-induced pulmonary arterial hypertension(PAH)in rats. Methods:Male Sprague-Dawley rats were randomly divided into 6 groups:control(Con)group,MCT group,MCT+10 μg/kg CDDO-NO (MCT+10NO)group,MCT+30 μg/kg CDDO-NO(MCT+30NO)group,MCT+7 μg/kg CDDO-Me(MCT+7Me)group and MCT+21 μg/kg CDDO-Me(MCT+21Me)group. PAH in rat was induced by a single dose injection of 60 mg/kg MCT intraperitoneally. The rats in each treatment groups were treated for daily aerosol CDDO -NO or CDDO -Me inhalation for 28 days. Right ventricular systolic pressure (RVSP)by right heart catheter,and right ventricular hypertrophy index(RVHI)as well as RV -to - body weight ratio(RV/BW)were measured. Hematoxylin-eosin(HE)staining was used to detect the pulmonary artery medial thickness(PAMT)and the morphological changes of the right ventricle. And α-smooth muscle actin(α-SMA)immunohistochemistry was used to investigate the muscularization of distal vessels. Masson’s trichrome staining(MTS)was performed to evaluate the fibrosis of arterioles. Results:Right heart catheter and right ventricular remodeling indicators showed that inhalation of either CDDO-NO or CDDO-Me suppressed elevations of RVSP, RVHI and RV/BW induced by MCT in PAH rats. CDDO-NO(30 μg/kg)showed stronger inhibitory effect in RVHI and RV/BW than that of the equal dose of parent compound CDDO-Me(21 μg/kg). Moreover,pathological studies indicated that 30 μg/kg CDDO-NO had better effects in alleviating right ventricular myocardial hypertrophy and PAMT,and reducing the proportion of fully muscularized vessels and the area of collagen deposition than those of CDDO-Me(21 μg/kg). Conclusion:Inhalation of CDDO-NO can ameliorate MCT-induced PAH in rats by inhibiting pulmonary vascular remodeling,and the effect of CDDO-NO is superior to parent compound CDDO-Me. These results suggest that CDDO-NO could be a promising drug for the treatment of PAH.