Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.
Department of Cardiology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Int J Clin Pract. 2021 Jul;75(7):e14171. doi: 10.1111/ijcp.14171. Epub 2021 Mar 30.
We explore the dual benefits of sildenafil on bi-ventricular functions in the form of improvement of ejection fraction, pulmonary vascular resistance and functional capacity of systolic heart failure patients either related to dilated or ischemic cardiomyopathy.
To evaluate the effect of oral sildenafil on biventricular function in patients with left ventricular systolic dysfunction.
The prospective randomised case-control study included 80 patients with left ventricular systolic dysfunction resulting from dilated or ischemic cardiomyopathy were equally randomised to one of the treatment groups in (1:1) who were collected from the outpatient clinic of cardiac care unit (CCU) of Beni-Suef University hospital; each group contained 40 patients: The first group (control group): received the guideline-recommended treatment of heart failure with reduced ejection fraction which consists of [angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), beta-blockers, aldosterone receptor antagonist, digoxin]. The second group (sildenafil group): received the previously mentioned guideline-recommended treatment in the control group plus sildenafil 25 mg three times per day. All patients were subjected to detailed history taking, baseline transthorathic echocardiography and exercise ECG using the Naughton protocol. Follow-up transthorathic echocardiography and exercise ECG was conducted after 3 months.
Sildenafil improves heart failure symptoms such as dyspnea or orthopnea or increasing the functional capacity of myocardium which is measured by estimated metabolic equivalents of task (METS) (P = .017), and exercise duration (P = .013). Sildenafil increased cardiac output (P = .033), which is considered one of the desirable targets in heart failure patients.
In patients with left ventricular systolic dysfunction secondary to dilated or ischemic cardiomyopathy, relatively small doses of sildenafil significantly enhances exercise period and functional ability, with substantial improvement in left ventricular systolic function irrespective of the existence of major pulmonary hypertension.
我们探索了西地那非在改善射血分数、肺血管阻力和收缩性心力衰竭患者功能能力方面对双心室功能的双重益处，这些患者与扩张型或缺血性心肌病有关。
评估口服西地那非对左心室收缩功能障碍患者双心室功能的影响。
这项前瞻性随机病例对照研究纳入了 80 名因扩张型或缺血性心肌病导致左心室收缩功能障碍的患者，他们来自贝尼苏夫大学医院心脏护理单元（CCU）的门诊，将他们以 1:1 的比例随机分为两组：治疗组（每组 40 名患者）。第一组（对照组）：接受指南推荐的射血分数降低的心力衰竭治疗，包括血管紧张素转换酶抑制剂（ACEIs）或血管紧张素受体阻滞剂（ARBs）、β受体阻滞剂、醛固酮受体拮抗剂、地高辛。第二组（西地那非组）：在对照组的基础上接受上述指南推荐的治疗，外加每天三次服用 25 毫克西地那非。所有患者均接受详细的病史采集、基线经胸超声心动图和使用 Naughton 方案的运动心电图检查。在 3 个月后进行随访经胸超声心动图和运动心电图检查。
西地那非改善了心力衰竭症状，如呼吸困难或端坐呼吸，或增加了心肌的功能能力，这是通过估计任务代谢当量（METS）来衡量的（P=0.017），以及运动时间（P=0.013）。西地那非增加了心输出量（P=0.033），这被认为是心力衰竭患者的一个理想目标。
在因扩张型或缺血性心肌病导致左心室收缩功能障碍的患者中，较小剂量的西地那非显著延长了运动时间和功能能力，左心室收缩功能显著改善，而不考虑是否存在严重的肺动脉高压。
