Effects of Myocardial Phosphodiesterase 5 Inhibitors on the Left Ventricular Function in Patients With Heart Failure: A Randomized Clinical Trial

Backgrounds: Myocardial phosphodiesterase 5 (PDE5) inhibitors are documented for use in various disease states. The efficacy of PDE5 inhibitors is less determined in heart failure patients without pulmonary hypertension. The aim of the present study was to evaluate the efficacy of PDE5 inhibitors in heart failure patients without pulmonary hypertension. Method: Seventy-six cases with heart failure were participated in this study. The selection criteria were systolic heart failure according to the New York Heart Association (NYHA) functional classifications I and IV, echocardiographically determined left ventricular ejection fraction less than 50%, and stability for at least 3 months. The participants were randomly divided into case and control groups. Both case and control groups received 50 mg of sildenafil and a placebo for 3 months, respectively. Transthoracic echocardiography (TTE) was performed using the Vingmed 800 CSF. All the ejection fraction measurements were done using the Simpson method. Before the initiation of the trial and then 3 months afterward, TTE was obtained from the participants. Changes in the functional class and the left ventricular ejection fraction before and after the trial were assessed and the data were analyzed using SPSS, version 16. Results: In the case group, the ejection fraction after the trial with an average of 41.53 +/- 7.53 was considerably more significant than that before the trial with an average of 37.92 +/- 6.92 (P < 0.001). The findings also showed that sildenafil inhibited PDE5 and the development of the NYHA IV when given for 90 days. As a result, sildenafil significantly improved the left ventricular ejection fraction. Conclusions: PDE5 inhibitors are effective in the treatment of heart failure patients without pulmonary hypertension.