Saetang Karun, Surachetpong Sirilak Disatian
Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.
Vet World. 2020 Oct;13(10):2260-2268. doi: 10.14202/vetworld.2020.2260-2268. Epub 2020 Oct 29.
Pulmonary hypertension (PH) is a common complication of degenerative mitral valve disease (DMVD). Sildenafil, a phosphodiesterase-5 inhibitor, has effects in reducing pulmonary arterial pressure by selectively dilating pulmonary vessels. The study aimed to evaluate the effects of sildenafil in combination with conventional therapy in dogs with PH caused by DMVD.
Fourteen dogs diagnosed with PH secondary to DMVD Stage C on conventional therapy were randomly assigned to placebo (n=7) and sildenafil (n=7) groups. On day 0, the recruited dogs underwent physical examinations, clinical score assessments, electrocardiography, systolic blood pressure measurements, blood collection, thoracic radiography, and echocardiography for baseline. The dogs then received a combination of conventional therapy with sildenafil or placebo every 8 h for 1 week. On day 7, all dogs underwent the baseline evaluations again.
The sildenafil group experienced a significant decrease in estimated systolic pulmonary artery pressure (sPAP) (p=0.043) from day 0 to day 7. Moreover, the total clinical scores were decreased in dogs treated with sildenafil relative to those who received the placebo (p=0.007); however, the lung scores were not different between before and after treatment with sildenafil.
Sildenafil had a synergistic effect with conventional therapy in reducing the estimated sPAP and clinical scores in dogs with PH secondary to DMVD.
肺动脉高压（PH）是退行性二尖瓣疾病（DMVD）的常见并发症。磷酸二酯酶-5抑制剂西地那非通过选择性扩张肺血管，具有降低肺动脉压的作用。本研究旨在评估西地那非联合传统疗法对DMVD所致PH犬的疗效。
将14只接受传统疗法治疗的DMVD C期继发PH犬随机分为安慰剂组（n = 7）和西地那非组（n = 7）。在第0天，对纳入的犬进行体格检查、临床评分评估、心电图检查、收缩压测量、采血、胸部X线摄影和超声心动图检查，以获取基线数据。然后，犬每8小时接受一次西地那非或安慰剂与传统疗法的联合治疗，持续1周。在第7天，所有犬再次进行基线评估。
从第0天到第7天，西地那非组的估计收缩期肺动脉压（sPAP）显著降低（p = 0.043）。此外，与接受安慰剂的犬相比，接受西地那非治疗的犬的总临床评分降低（p = 0.007）；然而，西地那非治疗前后的肺部评分没有差异。
西地那非与传统疗法联合使用，对降低DMVD继发PH犬的估计sPAP和临床评分具有协同作用。
