Sildenafil improves hemodynamic parameters in COPD - an investigation of six patients
Sildenafil improves hemodynamic parameters in COPD - an investigation of six patients
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DOI：
10.1016/j.pupt.2005.09.006
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发表时间：
2006-01-01
影响因子：
3.2
通讯作者：
Bastian, A.
中科院分区：
文献类型：
--
作者：
Alp, S.;Skrygan, M.;Bastian, A.
肺动脉高压（PH）是慢性阻塞性肺疾病（COPD）死亡率的重要预测指标。磷酸二酯酶5抑制剂西地那非已被证明可以降低不同疾病的肺动脉压。我们想要研究西地那非对6例严重慢性阻塞性肺病患者血液动力学参数和6分钟步行试验（6mwt）的影响，并通过超声心动图估计ph。在静脉注射50 mg西地那非前、1和12 h，通过右心导管进行6分钟步行试验和血液动力学参数测量。连续3个月口服西地那非50 mg，每日2次，最后重复血液动力学参数和6 MWT。静脉应用西地那非可显著降低PAP和肺血管阻力（PVR）。口服西地那非3个月后，平均PAP从30.2 +/- 5.5 mmHg（范围：24-39 mmHg）降至24.6 +/- 4.2 mmHg（范围：20-30 mmHg） （p = 0.01）。PVR由401 +/- 108 dyn s cm(-5)（范围：266-558dyn s cm(-5)）降至264 +/- 52 dyn s cm-5（范围：204-333 dyn s cm(-5)） （P < 0.05）。身体条件改善：6分钟步行距离从351 +/- 49米增加到433 +/- 52米。总之，在6例患有严重慢性阻塞性肺病的患者中，我们可以证明静脉应用50mg西地那非后血液动力学参数明显改善。口服西地那非3个月后，5例接受第二次右心导管的患者6 MWT步行距离和血流动力学参数显著增加。(c) 2005 Elsevier Ltd版权所有。
Pulmonary hypertension (PH) is an important predictor of mortality in chronic obstructive pulmonary disease (COPD). The phosphodiesterase 5 inhibitor sildenafil has been demonstrated to reduce pulmonary arterial pressure (PAP) in different diseases. We wanted to investigate the effect of sildenafil on hemodynamic parameters and the 6-min walk test (6 MWT) in six patients with severe COPD and echocardiographically estimated PH. A 6 MWT was performed and hemodynamic parameters were measured by right heart catheterization before and 1 and 12 h after injection of 50 mg sildenafil intravenously. A 3-months period of peroral sildenafil therapy 50 mg twice daily followed and finally hemodynamic parameters and a 6 MWT were repeated. Intravenously applied sildenafil could be demonstrated to reduce PAP and pulmonary vasculature resistance (PVR) significantly. And after 3 months of oral sildenafil, the mean PAP has decreased from 30.2 +/- 5.5 mmHg (range: 24-39 mmHg) to 24.6 +/- 4.2 mmHg (range: 20-30 mmHg) (p = 0.01). The PVR has decreased from 401 +/- 108 dyn s cm(-5) (range: 266-558dyn s cm(-5)) to 264 +/- 52 dyn s cm-5 (range: 204-333 dyn s cm(-5)) (P < 0.05). Physical conditions improved: the 6-min walk distance increased from 351 +/- 49 to 433 +/- 52 m. In conclusion, in six patients suffering from severe COPD we could demonstrate significantly improved hemodynamic parameters after 50 mg sildenafil intravenous application. And after 3 months of oral sildenafil, walking distance in the 6 MWT increased significantly as well as hemodynamic parameters in the five patients who had accepted a second right heart catheterization. (c) 2005 Elsevier Ltd. All rights reserved.