ERJ
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Published online before print August 9, 2007
Eur Respir J 2007, doi:10.1183/09031936.00039007
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
30/5/922    most recent
09031936.00039007v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Permissions
Right arrowRequest Permissions
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Reichenberger, F.
Right arrow Articles by Seeger, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Reichenberger, F.
Right arrow Articles by Seeger, W.

ORIGINAL ARTICLE

Long-term treatment with sildenafil in chronic thromboembolic pulmonary hypertension

F. Reichenberger 1*, R. Voswinckel 1, B. Enke 1, M. Rutsch 1, E.E. Fechtali 1, T. Schmehl 1, H. Olschewski 2, R. Schermuly 1, N. Weissmann 1, H.A. Ghofrani 1, F. Grimminger 1, E. Mayer 3, W. Seeger 1

1 University of Giessen Lung Centre, Dept of Internal Medicine, University Hospital Giessen, Klinikstrasse 36, 35392 Giessen, Germany
2 Division of Pulmonology, University Clinic for Internal Medicine, Medical University Graz, Austria
3 Dept of Cardio-Thoracic Surgery, University Hospital Mainz, Germany

* To whom correspondence should be addressed. E-mail: Frank.Reichenberger{at}uglc.de.


  Abstract

For chronic thromboembolic pulmonary hypertension (CTEPH) not amenable to pulmonary endarterectomy, effective medical therapy is desired.

In an open label, uncontrolled clinical trial 104 patients (mean age 62 [SD 11] years) with non-operable CTEPH were treated with 50 mg sildenafil TID. At baseline, patients had severe pulmonary hypertension (pulmonary vascular resistance (PVR) mean 863 [38] dynes * s * cm-5), a six minute walking distance (6MWD) of 310 [11] meters. Eight patients were in WHO functional class II, 76 patients in class III, and 20 patients in class IV.

After 3 months treatment, there was a significant haemodynamic improvement with reduction of PVR to 759 [62] dynes*s*cm-5 (p<0,001). The 6MWD significantly increased to 361 [15] meters after 3 months, and to 366 [18] meters after 12 months treatment (p=0.001 compared to baseline).

A subset of 67 patients received a single dose of 50mg sildenafil during initial right heart catheter. The acute haemodynamic effect was not predictive for long-term outcome.

In this large series of patients with non-operable CTEPH, open label treatment with sildenafil led to significant long-term functional improvement. The acute effect to sildenafil may not predict the long-term outcome of therapy.

Keywords:  Chronic thromboembolism, pulmonary hypertension, sildenafil




This article has been cited by other articles:


Home page
 Eur Heart JHome page
Authors/Task Force Members, N. Galie, M. M. Hoeper, M. Humbert, A. Torbicki, J.-L. Vachiery, J. A. Barbera, M. Beghetti, P. Corris, S. Gaine, et al.
Guidelines for the diagnosis and treatment of pulmonary hypertension: The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)
Eur. Heart J., October 2, 2009; 30(20): 2493 - 2537.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
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): S85 - S96.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Humbert
Update in Pulmonary Hypertension 2008
Am. J. Respir. Crit. Care Med., April 15, 2009; 179(8): 650 - 656.
[Full Text] [PDF]

Home page
 ESC Textbook of Cardiovascular MedicineHome page
N. Galiè and A. Manes
CHAPTER 24 Pulmonary Hypertension
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
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]

Home page
 ChestHome page
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]

Home page
 Eur Respir JHome page
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]

Home page
 Am. J. Respir. Crit. Care Med.Home page
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
Copyright © 2007 by the European Respiratory Society.