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One-year follow-up of the effects of sildenafil on pulmonary arterial hypertension and veno-occlusive disease
Barreto, A. C; Franchi, S. M; Castro, C. R. P; Lopes, A. A.
  • Barreto, A. C; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. Departamento de Cardiologia Pediátrica e Cardiopatias Congênitas. São Paulo. BR
  • Franchi, S. M; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. Departamento de Cardiologia Pediátrica e Cardiopatias Congênitas. São Paulo. BR
  • Castro, C. R. P; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. Departamento de Cardiologia Pediátrica e Cardiopatias Congênitas. São Paulo. BR
  • Lopes, A. A; Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. Departamento de Cardiologia Pediátrica e Cardiopatias Congênitas. São Paulo. BR
Braz. j. med. biol. res ; 38(2): 185-195, fev. 2005. ilus, tab
Article in English | LILACS | ID: lil-393654
Responsible library: BR1.1
ABSTRACT
We hypothesized that chronic oral administration of the phosphodiesterase-5 inhibitor sildenafil could improve the exercise capacity and pulmonary hemodynamics in patients with pulmonary arterial hypertension (PAH) on the basis of previous short-term studies. We tested this hypothesis in 14 subjects with PAH, including seven patients with the idiopathic form and seven patients with atrial septal defects, but no other congenital heart abnormalities. Patients were subjected to a 6-min walk test and dyspnea was graded according to the Borg scale. Pulmonary flow and pressures were measured by Doppler echocardiography. Patients were given sildenafil, 75 mg orally three times a day, and followed up for 1 year. Sildenafil therapy resulted in the following changes increase in the 6-min walk distance from a median value of 387 m (range 0 to 484 m) to 462 m (range 408 to 588 m; P < 0.01), improvement of the Borg dyspnea score from 4.0 (median value) to 3.0 (P < 0.01), and increased pulmonary flow (velocity-time integral) from a median value of 0.12 (range 0.08 to 0.25) to 0.23 (range 0.11 to 0.40; P < 0.01) with no changes in pulmonary pressures. In one patient with pulmonary veno-occlusive disease diagnosed by a lung biopsy, sildenafil had a better effect on the pulmonary wedge pressure than inhaled nitric oxide (15 and 29 mmHg, respectively, acute test). He walked 112 m at baseline and 408 m at one year. One patient died at 11 months of treatment. No other relevant events occurred. Thus, chronic administration of sildenafil improves the physical capacity of PAH patients and may be beneficial in selected cases of veno-occlusive disease.
Subject(s)
Full text: Available Index: LILACS (Americas) Main subject: Phosphodiesterase Inhibitors / Piperazines / Pulmonary Veno-Occlusive Disease / Hypertension, Pulmonary Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: Braz. j. med. biol. res Journal subject: Biology / Medicine Year: 2005 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Phosphodiesterase Inhibitors / Piperazines / Pulmonary Veno-Occlusive Disease / Hypertension, Pulmonary Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: Braz. j. med. biol. res Journal subject: Biology / Medicine Year: 2005 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR