PMID- 22129489
OWN - NLM
STAT- MEDLINE
DCOM- 20120320
LR  - 20151119
IS  - 1916-7075 (Electronic)
IS  - 0828-282X (Linking)
VI  - 28
IP  - 1
DP  - 2012 Jan-Feb
TI  - Hemodynamic and clinical benefits associated with chronic sildenafil therapy in 
      advanced heart failure: experience of the Montreal Heart Institute.
PG  - 69-73
LID - 10.1016/j.cjca.2011.09.018 [doi]
AB  - BACKGROUND: Pulmonary hypertension is highly prevalent in advanced heart failure 
      (HF) despite optimal medical and device therapies. The objective of this 
      investigation was to report on a single centre's experience of open-label chronic 
      sildenafil therapy in patients with advanced HF. METHODS: We conducted a 
      retrospective systematic medical record review of all patients evaluated at our 
      institution for heart transplantation who had also been treated with chronic 
      sildenafil therapy. Baseline demographics, comorbidities, and concomitant 
      medications, as well as the results of laboratory investigations and 
      physiological testing, were abstracted from patient medical records. Change in 
      systolic and mean pulmonary artery pressure (PAP), transpulmonary gradient, 
      cardiac output and cardiac index, and selected laboratory parameters was analyzed 
      by means of the Wilcoxon rank sum test. Outcomes of interest included New York 
      Heart Association (NYHA) functional class after 6 months of therapy and adverse 
      effects attributable to sildenafil. RESULTS: The 16 patients undergoing 
      evaluation for cardiac transplantation combined for 4166 patient-days on 
      sildenafil, with a mean dose of 102.5 +/- 54.0 mg/d. None discontinued because of 
      side effects. At 6 months, there was an improvement in the cardiac index (P = 
      0.014) and systolic PAP (P = 0.049) without any significant change in other 
      hemodynamic parameters. Ten patients (62.5%) experienced an improvement in their 
      NYHA functional class, 8 (50%) received a heart transplantation, and 2 (12.5%) 
      improved sufficiently to be removed from the transplant list. CONCLUSION: Chronic 
      sildenafil therapy was well tolerated and associated with improved functional 
      capacity and decreased systolic PAP. Properly controlled randomized studies of 
      the long-term usefulness of sildenafil therapy in advanced HF populations are 
      warranted.
CI  - Copyright (c) 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All 
      rights reserved.
FAU - Potter, Brian J
AU  - Potter BJ
AD  - Universite de Montreal, Montreal, Quebec, Canada.
FAU - White, Michel
AU  - White M
FAU - Carrier, Michel
AU  - Carrier M
FAU - Pellerin, Michel
AU  - Pellerin M
FAU - L'Allier, Philippe L
AU  - L'Allier PL
FAU - Pelletier, Guy B
AU  - Pelletier GB
FAU - Racine, Normand
AU  - Racine N
FAU - Ducharme, Anique
AU  - Ducharme A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20111129
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - 0 (Piperazines)
RN  - 0 (Purines)
RN  - 0 (Sulfones)
RN  - 0 (Vasodilator Agents)
RN  - BW9B0ZE037 (Sildenafil Citrate)
SB  - IM
MH  - *Academies and Institutes
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Hemodynamics/*drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Piperazines/*administration & dosage
MH  - Purines/administration & dosage
MH  - Quebec
MH  - Retrospective Studies
MH  - Sildenafil Citrate
MH  - Sulfones/*administration & dosage
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vasodilator Agents/administration & dosage
EDAT- 2011/12/02 06:00
MHDA- 2012/03/21 06:00
CRDT- 2011/12/02 06:00
PHST- 2011/08/12 00:00 [received]
PHST- 2011/09/16 00:00 [revised]
PHST- 2011/09/21 00:00 [accepted]
PHST- 2011/12/02 06:00 [entrez]
PHST- 2011/12/02 06:00 [pubmed]
PHST- 2012/03/21 06:00 [medline]
AID - S0828-282X(11)01292-X [pii]
AID - 10.1016/j.cjca.2011.09.018 [doi]
PST - ppublish
SO  - Can J Cardiol. 2012 Jan-Feb;28(1):69-73. doi: 10.1016/j.cjca.2011.09.018. Epub 
      2011 Nov 29.