Acute effects of 50 mg additive oral sildenafil on invasive exercise haemodynamics in pulmonary vascular disease
Abstract
Background and aims Patients with precapillary pulmonary hypertension (PH) due to pulmonary vascular disease (PVD) have reduced exercise capacity, limiting daily activity and quality of life. Phospodiesterase-5 inhibitors, including sildenafil, are used to treat PVD. This study examined effects of sildenafil on pulmonary haemodynamics during exercise in PVD. Method PVD patients diagnosed with pulmonary arterial hypertension (PAH) or chronic thromboembolic PH (CTEPH) underwent right heart catheterisation assessed at rest and during mild exercise. Main outcomes were mean pulmonary artery pressure (mPAP), cardiac output (CO) and the mPAP/CO slope before and ∼60 min after additive sildenafil (50 mg oral). Results 22 PVD patients (14 PAH, 8 CTEPH, 9 women and 15 pretreated (9 combination therapy)) with a mean±sd age of 54±14 years, mPAP 39±10 mmHg, CO 4.7±1.5 L·min−1 and pulmonary vascular resistance 6.9±3.8 WU were included. After sildenafil, mPAP and CO at rest were unchanged, but at end-exercise, mPAP and the mPAP/CO slope significantly decreased (mPAP 61±16 versus 54±16 mmHg; mean difference −7, 95% confidence interval (CI) −11 to −4; p<0.001 and mPAP/CO slope 9.8±4.9 versus 6.6±3.3; −3, 95% CI −4.9 to −1.2; p=0.002). The mean systemic arterial pressure was significantly lower after additive sildenafil at rest (−9 mmHg, −13 to −5; p<0.001) and at end-exercise (−9 mmHg, −13 to −5; p<0.001). One patient experienced dizziness. Conclusions Patients with PVD, showed favourable…
Read the paper
Related studies
- 2024 update in heart failure
- Vascular involvement in idiopathic pulmonary fibrosis
- A novel technique- subendometrial autologous platelet rich plasma injection in patients with unresponsive thin endometrium undergoing frozen-thawed embryo transfer: a prospective cohort study
- Does metformin prolong pregnancy in preterm pre-eclampsia? A study protocol for a South African, hospital-based double-blind, randomised, placebo-controlled trial
- Combined Pulmonary Fibrosis and Emphysema (CPFE): A "New" Smoking-Related Interstitial Lung Disease (ILD)
- Impact of an acute 1-month cannabidiol treatment on pain and inflammation after a long bone fracture: a triple-blind randomised, placebo-controlled, clinical trial protocol
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.