Key result
In patients with HFpEF, sildenafil decreased arterial elastance (-0.29 vs +0.02 mm Hg/mL; P=0.008) but reduced left ventricular contractility (ΔPWR/EDV -52 vs +0 mm Hg/s; P=0.006) compared to placebo.
Why the study?
Does sildenafil improve ventricular and vascular function in patients with heart failure and preserved ejection fraction?
Population
48 subjects with heart failure and preserved ejection fraction participating in a prospective ancillary…
Comparison
Sildenafil vs Placebo
Design
RCT
Authors
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Sildenafil's mixed ventricular-vascular effects in HFpEF warrant clinical caution; leaves open whether contractility reduction offsets vascular gains in larger trials.
RCT (n=48)
Does sildenafil improve ventricular and vascular function in patients with heart failure and preserved ejection fraction?
Absolute Event Rate: -0.29% vs 0.02%
p-value: p=0.008
In patients with HFpEF, sildenafil reduces systemic arterial load but impairs left ventricular contractility, potentially explaining the lack of clinical benefit observed in the RELAX trial.
Borlaug et al. (2015) conducted an RCT in Heart failure with preserved ejection fraction (n=48). Sildenafil vs. Placebo was evaluated on Arterial elastance (Ea) (p=0.008). In patients with HFpEF, sildenafil decreased arterial elastance (-0.29 vs +0.02 mm Hg/mL; P=0.008) but reduced left ventricular contractility (ΔPWR/EDV -52 vs +0 mm Hg/s; P=0.006) compared to placebo.
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