Sildenafil improves exercise capacity and quality of life in patients with systolic heart failure and secondary pulmonary hypertension
Sildenafil improves exercise capacity and quality of life in patients with systolic heart failure and secondary pulmonary hypertension
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DOI：
10.1161/circulationaha.107.716373
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发表时间：
2007-10-02
期刊：
影响因子：
37.8
通讯作者：
Semigran, Marc J.
中科院分区：
文献类型：
--
作者：
Lewis, Gregory D.;Shah, Ravi;Semigran, Marc J.
背景-与无肺动脉高压的收缩性心力衰竭患者相比，发生继发性肺动脉高压的收缩性心力衰竭患者运动能力降低，死亡率增加。降低肺血管阻力，提高HF合并PH患者的运动能力。将4名有症状的HF和PH患者随机分为西地那非（25 - 75 mg，口服，每日3次）或安慰剂治疗12周。患者在治疗前后进行心肺运动试验。主要终点，西地那非组的峰值VO 2较基线的变化（1.8 +/- 0.7 mL中心点kg（-1）中心点min（-1））大于安慰剂组（-0.27 mL中心点kg（-1）中心点min（-1）; P=0.02）。西地那非降低运动时肺血管阻力，增加心输出量（P
Background - Patients with systolic heart failure (HF) who develop secondary pulmonary hypertension (PH) have reduced exercise capacity and increased mortality compared with HF patients without PH. We tested the hypothesis that sildenafil, an effective therapy for pulmonary arterial hypertension, would lower pulmonary vascular resistance and improve exercise capacity in patients with HF complicated by PH.Methods and Results - Thirty-four patients with symptomatic HF and PH were randomized to 12 weeks of treatment with sildenafil (25 to 75 mg orally 3 times daily) or placebo. Patients underwent cardiopulmonary exercise testing before and after treatment. The change in peak VO2 from baseline, the primary end point, was greater in the sildenafil group (1.8 +/- 0.7 mL center dot kg(-1) center dot min(-1)) than in the placebo group (-0.27 mL center dot kg(-1) center dot min(-1); P=0.02). Sildenafil reduced pulmonary vascular resistance and increased cardiac output with exercise (P