PMID- 22116990
OWN - NLM
STAT- MEDLINE
DCOM- 20120619
LR  - 20151119
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 45
IP  - 12
DP  - 2011 Dec
TI  - Phosphodiesterase type 5 inhibitors as adjunctive therapy in the management of 
      systolic heart failure.
PG  - 1551-8
LID - 10.1345/aph.1Q421 [doi]
AB  - OBJECTIVE: To review the efficacy and safety of phosphodiesterase-5 (PDE5) 
      inhibitors in the treatment of patients with chronic systolic heart failure (HF). 
      DATA SOURCES: Literature was retrieved through MEDLINE (1966-September 2011) and 
      EMBASE (1980-September 2011), using the medical subject heading terms heart 
      failure and phosphodiesterase-5 inhibitors, sildenafil, tadalafil, and 
      vardenafil. Focus was placed on multidose trials of patients with systolic HF, 
      because of these trials' greater strength of clinical evidence. STUDY SELECTION 
      AND DATA EXTRACTION: All English-language, peer-reviewed publications were 
      analyzed for relevance. Studies appropriate to the objective were evaluated, 
      including 4 multidose trials investigating the effect of sildenafil on 
      cardiovascular function. DATA SYNTHESIS: In patients with New York Heart 
      Association class II or III HF, treatment with sildenafil was associated with 
      improvements in cardiac index, right ventricular ejection fraction, and other 
      markers of cardiovascular function, as well as reduced pulmonary arterial 
      pressure. Study durations ranged from 4 weeks to 1 year, and the studies used 
      varying doses of sildenafil, ranging from 75 to 225 mg/day, in divided doses. The 
      most common adverse effects associated with sildenafil therapy were headache and 
      flushing. CONCLUSIONS: Based on current studies, sildenafil appears to be well 
      tolerated and can improve markers of cardiovascular and pulmonary function in 
      patients with HF. PDE5 inhibitors may be a therapeutic option for patients who 
      cannot tolerate standard therapy for HF or who remain symptomatic with standard 
      therapy. Larger long-term trials are necessary to better understand the role of 
      PDE5 inhibitors in HF.
FAU - Cvelich, Ramonna G
AU  - Cvelich RG
AD  - Pharmacy Department, Durham Veterans Affairs Medical Center, Durham, NC, USA. 
      ghitea@gmail.com
FAU - Roberts, Sarah C
AU  - Roberts SC
FAU - Brown, Jamie N
AU  - Brown JN
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20111124
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Phosphodiesterase 5 Inhibitors)
RN  - 0 (Piperazines)
RN  - 0 (Purines)
RN  - 0 (Sulfones)
RN  - BW9B0ZE037 (Sildenafil Citrate)
SB  - IM
MH  - Chemotherapy, Adjuvant/methods
MH  - Clinical Trials as Topic
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Phosphodiesterase 5 Inhibitors/*adverse effects/*therapeutic use
MH  - Piperazines/adverse effects/therapeutic use
MH  - Purines/adverse effects/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Sildenafil Citrate
MH  - Sulfones/adverse effects/therapeutic use
EDAT- 2011/11/26 06:00
MHDA- 2012/06/20 06:00
CRDT- 2011/11/26 06:00
PHST- 2011/11/26 06:00 [entrez]
PHST- 2011/11/26 06:00 [pubmed]
PHST- 2012/06/20 06:00 [medline]
AID - aph.1Q421 [pii]
AID - 10.1345/aph.1Q421 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2011 Dec;45(12):1551-8. doi: 10.1345/aph.1Q421. Epub 2011 Nov 
      24.