Key result
In patients with left ventricular systolic dysfunction, adding oral sildenafil 25 mg three times daily to standard therapy significantly improved functional capacity (P=0.017) and exercise duration (P=0.013).
Why the study?
To evaluate the dual benefits and effects of oral sildenafil on biventricular function, pulmonary vascular resistance, and functional capacity in patients with left ventricular systolic dysfunction from dilated or ischemic cardiomyopathy.
Does oral sildenafil improve functional capacity and cardiac output in patients with left ventricular systolic dysfunction?
RCT (n=80)
1:1
No
Does oral sildenafil improve functional capacity and cardiac output in patients with left ventricular systolic dysfunction?
p-value: p=0.017
In patients with left ventricular systolic dysfunction, adding sildenafil 25 mg three times daily to standard therapy significantly improves functional capacity and cardiac output at 3 months.
May improve exercise tolerance in LV systolic dysfunction; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: We explore the dual benefits of sildenafil on bi-ventricular functions in the form of improvement of ejection fraction, pulmonary vascular resistance and functional capacity of systolic heart failure patients either related to dilated or ischemic cardiomyopathy. AIM OF THE WORK: To evaluate the effect of oral sildenafil on biventricular function in patients with left ventricular systolic dysfunction. PATIENTS AND METHODS: The prospective randomised case-control study included 80 patients with left ventricular systolic dysfunction resulting from dilated or ischemic cardiomyopathy were equally randomised to one of the treatment groups in (1:1) who were collected from the outpatient clinic of cardiac care unit (CCU) of Beni-Suef University hospital; each group contained 40 patients: The first group (control group): received the guideline-recommended treatment of heart failure with reduced ejection fraction which consists of [angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), beta-blockers, aldosterone receptor antagonist, digoxin]. The second group (sildenafil group): received the previously mentioned guideline-recommended treatment in the control group plus sildenafil 25 mg three times per day. All patients were subjected to detailed history taking, baseline transthorathic echocardiography and exercise ECG using the Naughton protocol. Follow-up transthorathic echocardiography and exercise ECG was conducted after 3 months. RESULTS: Sildenafil improves heart failure symptoms such as dyspnea or orthopnea or increasing the functional capacity of myocardium which is measured by estimated metabolic equivalents of task (METS) (P = .017), and exercise duration (P = .013). Sildenafil increased cardiac output (P = .033), which is considered one of the desirable targets in heart failure patients. CONCLUSION: In patients with left ventricular systolic dysfunction secondary to dilated or ischemic cardiomyopathy, relatively small doses of sildenafil significantly enhances exercise period and functional ability, with substantial improvement in left ventricular systolic function irrespective of the existence of major pulmonary hypertension.
No takes yet. Share an insight, caveat, or question.
Abdelaziz et al. (2021) conducted an RCT in Left ventricular systolic dysfunction (n=80). Sildenafil vs. Guideline-recommended treatment of heart failure was evaluated on Functional capacity measured by estimated metabolic equivalents of task (METS) (p=0.017). In patients with left ventricular systolic dysfunction, adding oral sildenafil 25 mg three times daily to standard therapy significantly improved functional capacity (P=0.017) and exercise duration (P=0.013).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: