Pulmonary vasodilation by sildenafil in acute intermediate-high risk pulmonary embolism: a randomized explorative trial

被引：13

作者：

Andersen, Asger ^{[1
]}

Waziri, Farhad ^{[1
]}

Schultz, Jacob Gammelgaard ^{[1
]}

Holmboe, Sarah ^{[1
]}

Becker, Soren Warberg ^{[2
]}

Jensen, Tage ^{[3
]}

Sondergaard, Hanne Maare ^{[4
]}

Dodt, Karen Kaae ^{[5
]}

May, Ole ^{[6
]}

Mortensen, Ulrik Markus ^{[1
]}

Kim, Won Yong ^{[1
]}

Mellemkjaer, Soren ^{[1
]}

Nielsen-Kudsk, Jens Erik ^{[1
]}

机构：

[1] Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark

[2] Reg Hosp Silkeborg, Diagnost Ctr, Silkeborg, Denmark

[3] Reg Hosp Randers, Dept Internal Med, Randers, Denmark

[4] Reg Hosp Viborg, Dept Cardiol, Viborg, Denmark

[5] Reg Hosp Horsens, Dept Internal Med, Horsens, Denmark

[6] Reg Hosp Herning, Dept Internal Med, Herning, Denmark

来源：

BMC PULMONARY MEDICINE | 2021年 / 21卷 / 01期

关键词：

Pulmonary embolism; Sildenafil; PDE5; inhibition; Pulmonary vasodilation; VENOUS THROMBOEMBOLISM; HYPERTENSION; MANAGEMENT;

D O I：

10.1186/s12890-021-01440-7

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: To investigate if acute pulmonary vasodilation by sildenafil improves right ventricular function in patients with acute intermediate-high risk pulmonary embolism (PE). Methods: Single center, explorative trial. Patients with PE were randomized to a single oral dose of sildenafil 50 mg (n = 10) or placebo (n = 10) as add-on to conventional therapy. The time from hospital admission to study inclusion was 2.3 +/- 0.7 days. Right ventricular function was evaluated immediately before and shortly after (0.5-1.5 h) randomization by right heart catheterization (RHC), trans-thoracic echocardiography (TTE), and cardiac magnetic resonance (CMR). The primary efficacy endpoint was cardiac index measured by CMR. Results: Patients had acute intermediate-high risk PE verified by computed tomography pulmonary angiography, systolic blood pressure of 135 +/- 18 (mean +/- SD) mmHg, increased right ventricular/left ventricular ratio 1.1 +/- 0.09 and increased troponin T 167 +/- 144 ng/L. Sildenafil treatment did not improve cardiac index compared to baseline (0.02 +/- 0.36 l/min/m(2), p = 0.89) and neither did placebo (0.00 +/- 0.34 l/min/m(2), p = 0.97). Sildenafil lowered mean arterial blood pressure (- 19 +/- 10 mmHg, p < 0.001) which was not observed in the placebo group (0 +/- 9 mmHg, p = 0.97). Conclusion: A single oral dose of sildenafil 50 mg did not improve cardiac index but lowered systemic blood pressure in patients with acute intermediate-high risk PE. The time from PE to intervention, a small patient sample size and low pulmonary vascular resistance are limitations of this study that should be considered when interpreting the results.

引用

页数：8

共 27 条

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