PMID- 15722248
OWN - NLM
STAT- MEDLINE
DCOM- 20050621
LR  - 20151119
IS  - 1537-1891 (Print)
IS  - 1537-1891 (Linking)
VI  - 42
IP  - 2
DP  - 2005 Jan
TI  - Early haemodynamic benefit of sildenafil in patients with coexisting chronic 
      thromboembolic pulmonary hypertension and left ventricular dysfunction.
PG  - 41-5
AB  - Sildenafil, a phosphodiesterase type-5 inhibitor, offers potential to treat 
      pulmonary hypertension associated with a variety of conditions. We assessed the 
      early impact of sildenafil on a cohort of patients referred to our unit who had 
      severe pulmonary hypertension secondary to chronic thromboembolic disease which 
      was not amenable to pulmonary thromboendarterectomy and who also had coexisting 
      left ventricular dysfunction. Six patients were studied. Diagnosis of pulmonary 
      embolic disease was made by ventilation perfusion scanning and/or CT pulmonary 
      angiography. All patients were anticoagulated with oral coumarin derivatives and 
      none were considered suitable for pulmonary thromboendarterectomy. Pulmonary 
      hypertension was diagnosed by right heart catheterisation and each patient had 
      Medical Research Council (MRC) dyspnoea score and New York Heart Association 
      (NYHA) class noted and 2D echocardiography prior to commencement of sildenafil 50 
      mg three times a day. After 6 weeks of sildenafil therapy, right heart 
      catheterisation and 2D echocardiography were repeated, and MRC dyspnoea score, 
      NYHA class and exercise capacity were recorded. All patients demonstrated an 
      improvement in mean pulmonary artery pressure, mean pulmonary capillary wedge 
      pressure, MRC dyspnoea score, NYHA class and gas transfer. No adverse effects of 
      sildenafil were noted. Our data suggests that sildenafil is an effective and 
      well-tolerated therapy for patients with severe pulmonary hypertension associated 
      with pulmonary thromboembolic disease and impaired left ventricular function, 
      producing beneficial effects as early as 6 weeks.
FAU - Sheth, Abhijat
AU  - Sheth A
AD  - Department of Cardiothoracic surgery, St Georges Hospital, London SW17 0QT, UK.
FAU - Park, John E S
AU  - Park JE
FAU - Ong, Yee Ean
AU  - Ong YE
FAU - Ho, Timothy B
AU  - Ho TB
FAU - Madden, Brendan P
AU  - Madden BP
LA  - eng
PT  - Journal Article
DEP - 20050118
PL  - United States
TA  - Vascul Pharmacol
JT  - Vascular pharmacology
JID - 101130615
RN  - 0 (Piperazines)
RN  - 0 (Purines)
RN  - 0 (Sulfones)
RN  - 0 (Vasodilator Agents)
RN  - BW9B0ZE037 (Sildenafil Citrate)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Output/drug effects
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/classification/complications/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Piperazines/*therapeutic use
MH  - Pulmonary Wedge Pressure/drug effects
MH  - Purines
MH  - Sildenafil Citrate
MH  - Sulfones
MH  - Treatment Outcome
MH  - Vasodilator Agents/*therapeutic use
MH  - Ventricular Dysfunction, Left/*complications
EDAT- 2005/02/22 09:00
MHDA- 2005/06/23 09:00
CRDT- 2005/02/22 09:00
PHST- 2004/10/21 00:00 [received]
PHST- 2004/11/11 00:00 [revised]
PHST- 2004/11/18 00:00 [accepted]
PHST- 2005/02/22 09:00 [pubmed]
PHST- 2005/06/23 09:00 [medline]
PHST- 2005/02/22 09:00 [entrez]
AID - S1537-1891(04)00117-X [pii]
AID - 10.1016/j.vph.2004.11.005 [doi]
PST - ppublish
SO  - Vascul Pharmacol. 2005 Jan;42(2):41-5. doi: 10.1016/j.vph.2004.11.005. Epub 2005 
      Jan 18.