Why the study?
Does sildenafil improve clinical condition in a patient with idiopathic pulmonary arterial hypertension unresponsive to beraprost and sarpogrelate?
Does sildenafil improve clinical condition in a patient with idiopathic pulmonary arterial hypertension unresponsive to beraprost and sarpogrelate?
Sildenafil may provide dramatic clinical improvement in patients with idiopathic pulmonary arterial hypertension who are unresponsive to other vasodilators like beraprost and sarpogrelate.
Should not change IPAH practice; single case leaves open need for controlled trials.
We report a 16-year-old man with severe heart failure due to idiopathic pulmonary arterial hypertension (IPAH). The patient was initially treated with a combination of beraprost, a prostacyclin analog, and sarpogrelate, a serotonin receptor inhibitor. However, he was unresponsive to the treatment. We then changed the treatment to sildenafil, and his condition dramatically improved. Sildenafil has an immediate pulmonary vasodilator effect in patients already receiving vasodilators for IPAH.
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Kawano et al. (2007) studied this question.
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