PMID- 17625080
OWN - NLM
STAT- MEDLINE
DCOM- 20070814
LR  - 20220409
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 132
IP  - 1
DP  - 2007 Jul
TI  - Right ventricular diastolic dysfunction and the acute effects of sildenafil in 
      pulmonary hypertension patients.
PG  - 11-7
AB  - AIMS: This study investigated whether right ventricular (RV) diastolic function 
      is impaired in pulmonary hypertension (PH) patients, and whether it is related to 
      RV mass and afterload. In addition, the effects of an acute reduction of RV 
      afterload by the oral intake of sildenafil were studied. Finally, we assessed 
      whether diastolic function is related to cardiac parameters of disease severity. 
      METHODS AND RESULTS: Twenty-five PH patients and 11 control subjects were 
      studied. Right-heart catheterization and N-terminal pro-brain natriuretic peptide 
      (NT-proBNP) sampling were performed in patients. MRI measured RV ejection 
      fraction, mass, and diastolic function. Isovolumic relaxation time (IVRT), 
      normalized early peak filling rate (E), atrium-induced peak filling rate (A), and 
      E/A ratio described diastolic function. Compared to control subjects, patients 
      had prolonged mean (+/- SD) IVRT (133.5 +/- 53.2 vs 29.3 +/- 20.8 ms, 
      respectively; p < 0.001), decreased E (3.0 +/- 1.6 vs 6.4 +/- 2.5 s(-1), 
      respectively; p < 0.001) and E/A ratio (1.1 +/- 0.7 vs 5.3 +/- 4.9, respectively; 
      p < 0.001), and increased A (3.0 +/- 1.4 vs 1.5 +/- 0.9 s(-1), respectively; p = 
      0.001). IVRT was related to RV mass (r(25) = 0.56; p = 0.005) and pulmonary 
      vascular resistance (r(25) = 0.74; p < 0.0001). Sildenafil therapy reduced RV 
      afterload and improved RV diastolic and systolic function. IVRT was correlated 
      with NT-proBNP level (r = 0.70; p < 0.001), and was inversely related to cardiac 
      index (r = -0.70; p < 0.001) and RV ejection fraction (r = -0.69; p < 0.001). 
      CONCLUSION: In PH patients, RV diastolic dysfunction is related to RV mass and 
      afterload. RV diastolic function improves by reducing afterload. The correlations 
      between diastolic function and prognostic parameters showed that diastolic 
      function is most impaired in patients with severe disease.
FAU - Gan, C Tji-Joong
AU  - Gan CT
AD  - VU University Medical Center, De Boelelaan 1117 PO Box 7057, 1007 MB Amsterdam, 
      the Netherlands.
FAU - Holverda, Sebastiaan
AU  - Holverda S
FAU - Marcus, J Tim
AU  - Marcus JT
FAU - Paulus, Walter J
AU  - Paulus WJ
FAU - Marques, Koen M
AU  - Marques KM
FAU - Bronzwaer, Jean G F
AU  - Bronzwaer JG
FAU - Twisk, Jos W
AU  - Twisk JW
FAU - Boonstra, Anco
AU  - Boonstra A
FAU - Postmus, Pieter E
AU  - Postmus PE
FAU - Vonk-Noordegraaf, Anton
AU  - Vonk-Noordegraaf A
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Piperazines)
RN  - 0 (Purines)
RN  - 0 (Sulfonamides)
RN  - 0 (Sulfones)
RN  - 0 (Vasodilator Agents)
RN  - 31C4KY9ESH (Nitric Oxide)
RN  - BW9B0ZE037 (Sildenafil Citrate)
RN  - DCR9Z582X0 (Epoprostenol)
RN  - Q326023R30 (Bosentan)
SB  - IM
CIN - Chest. 2007 Jul;132(1):2-5. PMID: 17625076
MH  - Adult
MH  - Antihypertensive Agents/therapeutic use
MH  - Blood Circulation/physiology
MH  - Blood Pressure/physiology
MH  - Bosentan
MH  - Epoprostenol/therapeutic use
MH  - Female
MH  - Heart Ventricles/pathology/physiopathology
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/physiopathology
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Nitric Oxide/therapeutic use
MH  - Piperazines/*therapeutic use
MH  - Purines/therapeutic use
MH  - Severity of Illness Index
MH  - Sildenafil Citrate
MH  - Stroke Volume/physiology
MH  - Sulfonamides/therapeutic use
MH  - Sulfones/*therapeutic use
MH  - Vascular Resistance/physiology
MH  - Vasodilator Agents/*therapeutic use
MH  - Ventricular Dysfunction, Right/*physiopathology
EDAT- 2007/07/13 09:00
MHDA- 2007/08/19 09:00
CRDT- 2007/07/13 09:00
PHST- 2007/07/13 09:00 [pubmed]
PHST- 2007/08/19 09:00 [medline]
PHST- 2007/07/13 09:00 [entrez]
AID - S0012-3692(15)35677-4 [pii]
AID - 10.1378/chest.06-1263 [doi]
PST - ppublish
SO  - Chest. 2007 Jul;132(1):11-7. doi: 10.1378/chest.06-1263.