Document Detail

Clinical and haemodynamic effects of sildenafil in pulmonary hypertension: acute and mid-term effects.
MedLine Citation:
PMID:  15033256     Owner:  NLM     Status:  MEDLINE    
AIM: The treatment of patients with pulmonary arterial hypertension remains a challenge. We set out to investigate the use of sildenafil, a selective inhibitor of phosphodiesterase type 5, in patients with this disease. METHODS AND RESULTS: Ten patients (8 females, mean age 34.5+/-3.3 years) with pulmonary hypertension underwent right heart catheterisation with vasodilator testing using incremental doses of intravenous sildenafil without adverse events. All patients were subsequently commenced on oral sildenafil 50 mg t.d.s. Nine patients had repeat right heart catheterisation 3 months after the commencement of oral therapy. There was a significant reduction in mean pulmonary artery pressure (from 55.8+/-5.9 to 50.4+/-6.1 mmHg, p=0.038 ) and pulmonary vascular resistance (from 10.1+/-1.7 to 8.6+/-1.5 Wood units, p=0.009 ), and an increase in cardiac output (from 4.7+/-0.3 to 5.0+/-0.4 l/min, p=0.15 ). Furthermore, there was a significant increase in the 6-minute walk test, a mean of 112 m. In response to a quality-of-life questionnaire, patients indicated marked clinical improvement on sildenafil. Sildenafil was discontinued in 1 patient due to a transient visual disturbance. The only patient previously awaiting transplantation was removed from the active transplantation list. CONCLUSIONS: Sildenafil is well tolerated in its intravenous and oral forms and appears to improve both pulmonary haemodynamics and the clinical status of patients with pulmonary hypertension after 3 months of oral therapy.
Ghada W Mikhail; Sanjay K Prasad; Wei Li; Paula Rogers; Adrian H Chester; Stephanie Bayne; David Stephens; Mohammed Khan; J S R Gibbs; Timothy W Evans; Andrew Mitchell; Magdi H Yacoub; Michael A Gatzoulis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  25     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-22     Completed Date:  2004-07-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  431-6     Citation Subset:  IM    
Adult Congenital Heart Unit, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP UK.
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MeSH Terms
Administration, Oral
Blood Pressure / drug effects
Hemodynamics / drug effects*
Hypertension, Pulmonary / drug therapy*,  physiopathology
Infusions, Intravenous
Middle Aged
Phosphodiesterase Inhibitors / administration & dosage*
Piperazines / administration & dosage*
Vascular Resistance / drug effects
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Sulfones; 139755-83-2/sildenafil

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