The immediate effect of sildenafil on right ventricular function in patients with heart failure measured by cardiac magnetic resonance: a randomized control trial.

<h4>Background</h4>Studies have demonstrated that phosphodiesterase 5 (PDE5) inhibition is associated with right ventricle (RV) functional improvement in patients with primary pulmonary hypertension. This study aims to demonstrate the immediate impact of Sildenafil, a PDE5 inhibitor, on...

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Main Authors: André Maurício S Fernandes, Agnes Carvalho Andrade, Natalia Duarte Barroso, Igor Carmo Borges, Dafne Carvalho-Andrade, Erenaldo S Rodrigues Junior, Libia Castro Guimarães, André Rodrigues Durães, Sirlene Mendes Borges, Roque Aras Junior
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0119623&type=printable
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Summary:<h4>Background</h4>Studies have demonstrated that phosphodiesterase 5 (PDE5) inhibition is associated with right ventricle (RV) functional improvement in patients with primary pulmonary hypertension. This study aims to demonstrate the immediate impact of Sildenafil, a PDE5 inhibitor, on RV function, measured by cardiovascular magnetic resonance (CMR), in patients with heart failure (HF).<h4>Methods</h4>We conducted a randomized double-blind controlled trial.<h4>Inclusion criteria</h4>diagnosis of HF functional class I-III; left ventricle ejection fraction < 35%. Patients underwent CMR evaluation and were then equally randomly assigned to either 50 mg of Sildenafil or Placebo groups. One hour following drug administration, they were submitted to a second scan examination.<h4>Results</h4>26 patients were recruited from a tertiary reference center in Brazil and 13 were allocated to each study group. The median age was 61.5 years (50-66.5 years). Except for the increase in RV fractional area change following the administration of sildenafil (Sildenafil [before vs. after]: 34.3 [25.2-43.6]% vs. 42.9 [28.5-46.7]%, p = 0.04; Placebo [before vs. after]: 28.1 [9.2-34.8]% vs. 29.2 [22.5-38.8]%, p = 0.86), there was no statistically significant change in parameters. There was no improvement in left ventricular parameters or in the fractional area change of the pulmonary artery.<h4>Conclusion</h4>This study demonstrated that a single dose of Sildenafil did not significantly improve RV function as measured by the CMR.<h4>Trial registration</h4>ClinicalTrials.gov NCT01936350.
ISSN:1932-6203