Narváez DR, Dorantes GJ, Hernández RP, Asensio LE, Orea TA, Rebollar GV, Castillo L, Galindo UJ, Oseguera MJ

Language: Spanish
References: 12
Page: 292-296
PDF size: 251.33 Kb.

ABSTRACT

Background: Pulmonary artery hypertension has several aethiologies and its treatment depends upon them. Sildenafil, a selective inhibitor of 5-phosphodiesterase, might be useful in the treatment of diverse aethiologies pulmonary artery hypertension.
Objective: To assess the acute pharmacological effect of sildenafil on pulmonary artery hypertension of different causes.
Patients and methods: A prospective, linear and controlled study in order to compare sildenafil’s ability to modify pulmonary artery pressures against oxygen and adenosine was carried out.
Results: We performed 14 right heart catheterizations among patients with pulmonary artery hypertension of different aethiologies. Echocardiogram showed a mean pulmonary artery hypertension of 84.2 ± 21.3 mmHg. Sildenafil reduced PASP from 77.6 ± 22.4 mmHg to 59.8±21.9 mmHg (p › 0.001). This reduction was significantly higher when compared to the reductions achieved with oxygen (71.5 ± 20.5 mmHg) and adenosine (73.6 ± 22.4 mmHg). The PASP achieved with sildenafil represents a 24.6% reduction, a 27.2% for diastolic PAP and a 25.4% reduction for mean PAP. Vascular lung resistances diminished about 200 dynes/seg (p ‹ 0.001).
Conclusion: Sildenafil is a useful medication for the treatment of pulmonary artery hypertension from different aethiologies, since it significantly lowers PASP, mean PA pressure and vascular lung resistances without modifying systemic resistances. It can be useful as a part of the pharmacological challenge test. Its usefulness as a long-term therapy needs to be evaluated.

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