|
 |
|
|||||||
|
|||||||||
Copyright ©ERS Journals Ltd 2007
Long-term treatment with sildenafil in chronic thromboembolic pulmonary hypertension
1 University of Giessen Lung Centre, Dept of Internal Medicine, Giessen University Hospital, Giessen, 3 Dept of Cardiothoracic Surgery, Mainz University Hospital, Mainz, Germany. 2 Division of Pulmonology, University Clinic for Internal Medicine, Graz Medical University, Graz, Austria.
CORRESPONDENCE: F. Reichenberger, University of Giessen Lung Centre, University Hospital Giessen, Klinikstrasse 36, 35392 Giessen, Germany. Fax: 49 6419942599. E-mail: Frank.Reichenberger{at}innere.med.uni-giessen.de
Keywords: Chronic thromboembolism, pulmonary hypertension, sildenafil
Received: April 2, 2007
Accepted July 25, 2007
For chronic thromboembolic pulmonary hypertension not amenable to pulmonary endarterectomy, effective medical therapy is desired.
In an open-label uncontrolled clinical trial, 104 patients (mean±SEM age 62±11 yrs) with inoperable chronic thromboembolic pulmonary hypertension were treated with 50 mg sildenafil t.i.d. At baseline, patients had severe pulmonary hypertension (pulmonary vascular resistance 863±38 dyn·s·cm–5) and a 6-min walking distance of 310±11 m. Eight patients were in World Health Organization functional class II, 76 in class III and 20 in class IV.
After 3 months’ treatment, there was significant haemodynamic improvement, with reduction of pulmonary vascular resistance to 759±62 dyn·s·cm–5. The 6-min walking distance increased significantly to 361±15 m after 3 months’ treatment, and to 366±18 m after 12 months’ treatment. A subset of 67 patients received a single dose of 50 mg sildenafil during initial right heart catheterisation. The acute haemodynamic effect of this was not predictive of long-term outcome.
In this large series of patients with inoperable chronic thromboembolic pulmonary hypertension, open-label treatment with sildenafil led to significant long-term functional improvement. The acute effect of sildenafil may not predict the long-term outcome of therapy.
This article has been cited by other articles:
|
|
 |
|
  M. M. Hoeper, J. A. Barbera, R. N. Channick, P. M. Hassoun, I. M. Lang, A. Manes, F. J. Martinez, R. Naeije, H. Olschewski, J. Pepke-Zaba, et al. Diagnosis, Assessment, and Treatment of Non-Pulmonary Arterial Hypertension Pulmonary Hypertension J. Am. Coll. Cardiol., June 30, 2009; 54(1_Suppl_S): S85 - S96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Humbert Update in Pulmonary Hypertension 2008 Am. J. Respir. Crit. Care Med., April 15, 2009; 179(8): 650 - 656. [Full Text] [PDF]
|
|
|
|
|
|
X. Jais, A. M. D'Armini, P. Jansa, A. Torbicki, M. Delcroix, H. A. Ghofrani, M. M. Hoeper, I. M. Lang, E. Mayer, J. Pepke-Zaba, et al. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J. Am. Coll. Cardiol., December 16, 2008; 52(25): 2127 - 2134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Suntharalingam, C. M. Treacy, N. J. Doughty, K. Goldsmith, E. Soon, M. R. Toshner, K. K. Sheares, R. Hughes, N. W. Morrell, and J. Pepke-Zaba Long-term Use of Sildenafil in Inoperable Chronic Thromboembolic Pulmonary Hypertension Chest, August 1, 2008; 134(2): 229 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Wilkins, J. Wharton, F. Grimminger, and H. A. Ghofrani Phosphodiesterase inhibitors for the treatment of pulmonary hypertension Eur. Respir. J., July 1, 2008; 32(1): 198 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Condliffe, D. G. Kiely, J. S. R. Gibbs, P. A. Corris, A. J. Peacock, D. P. Jenkins, D. Hodgkins, K. Goldsmith, R. J. Hughes, K. Sheares, et al. Improved Outcomes in Medically and Surgically Treated Chronic Thromboembolic Pulmonary Hypertension Am. J. Respir. Crit. Care Med., May 15, 2008; 177(10): 1122 - 1127. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |