Document Detail


Sildenafil is more selective pulmonary vasodilator than prostaglandin E1 in patients with pulmonary hypertension due to heart failure.
MedLine Citation:
PMID:  21114369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H Al-Hiti; V Melenovský; P Syrovátka; J Kettner; I Málek; J Kautzner
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-29
Journal Detail:
Title:  Physiological research / Academia Scientiarum Bohemoslovaca     Volume:  60     ISSN:  1802-9973     ISO Abbreviation:  Physiol Res     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-10     Completed Date:  2011-09-09     Revised Date:  2011-10-21    
Medline Journal Info:
Nlm Unique ID:  9112413     Medline TA:  Physiol Res     Country:  Czech Republic    
Other Details:
Languages:  eng     Pagination:  303-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. hial@ikem.cz
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MeSH Terms
Descriptor/Qualifier:
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:
0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 139755-83-2/sildenafil; 745-65-3/Alprostadil

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


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