Sildenafil for Long-Term Treatment of Nonoperable Chronic Thromboembolic Pulmonary Hypertension
Why the study?
Does oral sildenafil improve hemodynamics and exercise capacity in patients with nonoperable chronic thromboembolic pulmonary hypertension?
Population
12 patients with nonoperable chronic thromboembolic pulmonary hypertension in disease progression despite…
Design
Case_series
Follow-up
approximately 6 months
Authors
Discussion
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Member takes
Implication
Should not yet change practice; hypothesis-generating for sildenafil in nonoperable CTEPH.
Key Points
- To assess the effects of oral sildenafil on pulmonary hemodynamics and exercise capacity in patients with inoperable chronic thromboembolic pulmonary hypertension.
- Investigated 12 patients with severe, progressive nonoperable chronic thromboembolic pulmonary hypertension despite standard anticoagulation and supportive care.
- Administered oral sildenafil and evaluated changes after approximately 6 months of continuous therapy.
- Pulmonary vascular resistance index decreased from 1,935 ± 228 dyn·s·cm⁻⁵·m² at baseline to 1,361 ± 177 dyn·s·cm⁻⁵·m² (p = 0.004).
- Cardiac index increased from 2.0 L·min⁻¹·m⁻² to 2.4 ± 0.2 L·min⁻¹·m⁻² (p = 0.009).
- Exercise capacity significantly improved, with 6-minute walking distance increasing from 312 ± 30 m to 366 ± 28 m (p = 0.02).
Structured PICO
Does oral sildenafil improve hemodynamics and exercise capacity in patients with nonoperable chronic thromboembolic pulmonary hypertension?
P
Population
12 patients with nonoperable chronic thromboembolic pulmonary hypertension in disease progression despite sufficient long-term anticoagulation and best supportive care.
I
Intervention
Oral sildenafil for approximately 6 months.
O
Outcome
Hemodynamics (pulmonary vascular resistance index, cardiac index) and exercise capacity (6-minute walking distance) at approximately 6 months.surrogate
Oral sildenafil significantly improves pulmonary hemodynamics and exercise capacity in patients with severe, nonoperable chronic thromboembolic pulmonary hypertension.
Cite This Study
Ghofrani et al. (2003) studied this question.