| Sildenafil is more selective pulmonary vasodilator than prostaglandin E1 in patients with pulmonary hypertension due to heart failure. | |
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MedLine Citation:
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PMID: 21114369 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In some patients, heart failure (HF) is associated with increased pulmonary vascular resistance (PVR). The magnitude and the reversibility of PVR elevation affect the HF management. Sildenafil has been recently recognized as potent PVR-lowering drug in HF. The aim of the study was to compare hemodynamic effects and pulmonary selectivity of sildenafil to prostaglandin E(1) (PGE(1)). Right-heart catheterization was performed in 13 euvolemic advanced HF patients with elevated PVR (6.3+/-2 Wood's units). Hemodynamic parameters were measured at the baseline, during i.v. infusion of PGE1 (alprostadil 200 ng · kg(-1) · min(-1)) and after 40 mg oral dose of sildenafil. Both drugs similarly reduced systemic vascular resistance (SVR), but sildenafil had higher effect on PVR (-28 % vs. -49 %, p = 0.05) and transpulmonary pressure gradient than PGE(1). The PVR/SVR ratio--an index of pulmonary selectivity, did not change after PGE(1) (p = 0.7) but it decreased by -32 % (p = 0.004) after sildenafil. Both drugs similarly reduced pulmonary artery mean and wedge pressures and increased cardiac index (+27 % and +28 %). Sildenafil led more often to transplant-acceptable PVR while causing smaller drop of mean systemic pressure than PGE(1). In conclusion, vasodilatatory effects of sildenafil in patients with heart failure are more pronounced in pulmonary than in systemic circulation. |
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Authors:
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H Al-Hiti; V Melenovský; P Syrovátka; J Kettner; I Málek; J Kautzner |
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Publication Detail:
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Type: Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-11-29 |
Journal Detail:
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Title: Physiological research / Academia Scientiarum Bohemoslovaca Volume: 60 ISSN: 1802-9973 ISO Abbreviation: Physiol Res Publication Date: 2011 |
Date Detail:
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Created Date: 2011-05-10 Completed Date: 2011-09-09 Revised Date: 2011-10-21 |
Medline Journal Info:
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Nlm Unique ID: 9112413 Medline TA: Physiol Res Country: Czech Republic |
Other Details:
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Languages: eng Pagination: 303-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. hial@ikem.cz |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Alprostadil / therapeutic use* Cardiac Output / drug effects Female Heart Catheterization Heart Failure / complications, drug therapy* Humans Hypertension, Pulmonary / drug therapy*, etiology Male Middle Aged Piperazines / therapeutic use* Pulmonary Artery / drug effects Pulmonary Wedge Pressure / drug effects Purines / therapeutic use Sulfones / therapeutic use* Vascular Resistance / drug effects Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 139755-83-2/sildenafil; 745-65-3/Alprostadil |
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