Long-Term Use of Sildenafil in the Therapeutic Management of Heart Failure

摘要: Long-Term Use of Sildenafil in the Therapeutic Management Heart Failure Marco Guazzi, Michele Samaja, Ross Arena, Marco Vicenzi, Maurizio D. Guazzi We tested whether chronic phosphodiesterase 5 inhibition by sildenafil is beneficial heart failure. A total 46 failure patients were randomly assigned to placebo (23 patients) or patients), with 3- and 6-month assessments cardiopulmonary exercise test performance, brachial artery flow-mediated maximal dilatation, ergoreflex responses. not improved effect on ventilation, ventilation CO2production slope, breathlessness, at both 3 6 months (p < 0.01). Findings suggest that benefits are sustained an endothelium-mediated modulation muscle oversignaling may be work. Objectives This study sought functional capacity endothelial function a cohort (CHF) treated type (PDE5) inhibitor. Background In CHF, dysfunction involved underperfusion, oversignaling, inefficiency. Inhibition PDE5by improving might beneficial. Methods Stable CHF dose 50 mg twice per day addition their current drug treatment for months, (at months) dilatation (FMD), testing, response. Results group only, we observed reduction systolic pulmonary pressure (from 33.7 25.2 mm Hg 23.9 Hg), 6.9 2.3 l·min−1and 1.9 l·min−1), slope (VE/Vco2, from 35.5 32.1 29.8), breathlessness (score) 23.6 16.6 17.2), increase FMD 8.5% 13.4% 14.2%), peak Vo2(from 14.8 18.5 ml·min−1·kg−1and 18.7 ml·min−1·kg−1), ratio Vo2to work rate changes 7.7 9.3 10.1). All significant p 0.01. group, correlation was found between those ergoreflex. Changes correlated Vo2and VE/Vco2slope. No adverse effects noted except flushing patients. Conclusions improvement aerobic efficiency significantly related attenuation exercising oversignaling. Chronic seems remedy based pathophysiology devoid remarkable effects.