Document Detail

Sildenafil has no effect on portal pressure but lowers arterial pressure in patients with compensated cirrhosis.
MedLine Citation:
PMID:  20144739     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: The reduction of portal pressure in patients with early compensated cirrhosis may be more responsive to drugs increasing intrahepatic vasodilatation than those reducing portal venous inflow. The phosphodiesterase-5 (PDE-V) inhibitor sildenafil can potentially reduce portal pressure by decreasing intrahepatic resistance, but its systemic vasodilatory effects may be deleterious. The aim of this study was to evaluate the effect of sildenafil on systemic and portal hemodynamics in an open-label pilot study.
METHODS: Twelve patients with compensated cirrhosis and baseline hepatic venous pressure gradient (HVPG) >5 mm Hg received 25 mg of oral sildenafil. Mean arterial pressure (MAP), heart rate (HR), and HVPG were repeated after 30 and 60 minutes in 9/12 patients at 90 minutes (after an additional 25 mg of sildenafil). HVPG tracings were read by 3 blinded observers.
RESULTS: All 12 patients were Child A with median MAP of 92 mm Hg (interquartile range, 83-94) and HVPG 10.4 mm Hg (interquartile range, 6.6-13.0). While MAP decreased significantly at all time points, sildenafil had no effect on HVPG.
CONCLUSIONS: As shown with other vasodilators in compensated cirrhotic patients, sildenafil at therapeutic doses for erectile dysfunction reduces MAP without reducing portal pressure. The search should continue for specific intrahepatic vasodilators.
Puneeta Tandon; Irteza Inayat; Michael Tal; Marcelo Spector; Martha Shea; Roberto J Groszmann; Guadalupe Garcia-Tsao
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-02-06
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  8     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-01     Completed Date:  2010-09-14     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  546-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Blood Pressure / drug effects*
Heart Rate / drug effects
Liver Cirrhosis / drug therapy*
Middle Aged
Pilot Projects
Piperazines / administration & dosage*,  pharmacology
Prospective Studies
Purines / administration & dosage,  pharmacology
Sulfones / administration & dosage*,  pharmacology
Vasodilator Agents / administration & dosage*,  pharmacology
Grant Support
K24 DK002727/DK/NIDDK NIH HHS; K24 DK002727-10/DK/NIDDK NIH HHS; P30 DK034989/DK/NIDDK NIH HHS; P30 DK034989-25S19005/DK/NIDDK NIH HHS; P30 DK34989/DK/NIDDK NIH HHS
Reg. No./Substance:
0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 3M7OB98Y7H/sildenafil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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