Bussotti Maurizio, Montorsi Piero, Amato Mauro, Magini Alessandra, Baldassarre Damiano, Tantardini Francesca, Veglia Fabrizio, Agostoni Piergiuseppe
Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, via Parea 4, 20138, Milan, Italy.
Int J Cardiol. 2008 May 7;126(1):68-72. doi: 10.1016/j.ijcard.2007.03.118. Epub 2007 May 8.
Sildenafil is used for pulmonary hypertension treatment and its use is safe in chronic heart failure (HF) patients.
To analyze the effects of sildenafil on lung mechanics, gas diffusion, exhaled nitric oxide (eNO) at rest and during exercise in chronic HF. We did so to evaluate if sildenafil prevents exercise-induced pulmonary edema formation.
We studied 22 chronic HF males. We measured after a single dose of placebo, sildenafil (25 mg) and sildenafil (100 mg), lung diffusion (DLCO), molecular diffusion (DM), pulmonary capillary volume (VC), eNO, all at rest and during exercise, standard pulmonary function, and maximal cardiopulmonary exercise.
At rest sildenafil improved pulmonary mechanics and DLCO from 23.1+/-6.3 ml/mmHg/min to 23.9+/-6.4 (25 mg, p<0.05) and to 25.3+/-6.7 100 mg, p<0.02). Sildenafil (100 mg) prevents edema formation (highest DM/VC during exercise). At rest eNO was low and not affected by tested drugs. With light exercise eNO was higher with sildenafil 100 mg. Peak VO(2) increased with sildenafil from 1376+/-331 ml/min to 1471+/-375 (25 mg, p<0.01) and 1524+/-461 (100 mg, p<0.02). Peak VO(2) increase was related to DLCO improvement.
In chronic HF sildenafil increases exercise performance, improves lung mechanics and gas diffusion and prevents exercise-induced pulmonary edema formation probably by restoring NO pathways.
西地那非用于治疗肺动脉高压，且在慢性心力衰竭（HF）患者中使用是安全的。
分析西地那非对慢性HF患者静息及运动时肺力学、气体扩散、呼出一氧化氮（eNO）的影响。我们这样做是为了评估西地那非是否能预防运动诱发的肺水肿形成。
我们研究了22名慢性HF男性患者。在单次服用安慰剂、25毫克西地那非和100毫克西地那非后，我们测量了静息及运动时的肺扩散（DLCO）、分子扩散（DM）、肺毛细血管容积（VC）、eNO、标准肺功能和最大心肺运动。
静息时，西地那非改善了肺力学，DLCO从23.1±6.3毫升/毫米汞柱/分钟提高到23.9±6.4（25毫克，p<0.05）和25.3±6.7（100毫克，p<0.02）。西地那非（100毫克）可预防水肿形成（运动时最高DM/VC）。静息时eNO较低，且不受受试药物影响。轻度运动时，100毫克西地那非组的eNO较高。西地那非使峰值VO(2)从1376±331毫升/分钟增加到1471±375（25毫克，p<0.01）和1524±461（100毫克，p<0.02）。峰值VO(2)的增加与DLCO的改善有关。
在慢性HF中，西地那非可能通过恢复NO途径提高运动能力，改善肺力学和气体扩散，并预防运动诱发的肺水肿形成。
