Pulmonary hypertension syndrome in dilation cardiomyopathy patients: sildenafil application to common treatment of chronic heart failure
https://doi.org/10.15829/1728-8800-2016-1-51-57
Abstract
Aim. To assess clinical and hemodynamic efficacy of sildenafil at the background of basic therapy in patients with idiopathic and right ventricular (RV) dilated cardiomyopathy.
Material and methods. Totally, 59 patients with idiopathic DCMP included. All patients were selected to 2 groups: I (n=28); M/F 15/13; 46,9 ±11,4 y.o., and II (n=31); M/F 17/14; 46,3±15,4 y.o. Number of patients with RV DCMP in each group was 10 (35,7%) and 13 (41,9%), resp. They underwent clinical status assessment by SCAHF, 6-minute walking test, standard ECG, echocardiography via transthoracic approach. Patients of the 1st group additionally to basic therapy of heart failure were prescribed sildenafil in individual dosage — mean 45,8±12,5 mg/day. Duration of the study was 6 months.
Results. Women, consisting 45,7% in general, significantly predominated among patients with RV DCMP. By the results of the study there was regression of the mean points by SCAHF by 30,1% and 40,8%, increase of 6-minute distance by 50,1% and 45,8% in patients of I and II groups, respectively. At the background of sildenafil addition, there was significant decrease of systolic pressure in pulmonary artery in I group by 23,8% (p=0,031), that helped to decrease end-diastolic pressure in RV chamber and increased RV ejection fraction by 6,3%. In i group patients there was increase of diastolic reserve of RV due to improvement of active Ve by 29,1% (p=0,01) and Va by 54% (p=0,03), that led to a decrease of Ve/Va ratio by 38% (p<0,05). The assessment of spirometry showed that combination therapy by sildenafil led to significant increase of Tiffeneau and Gaensler indexes by 23,4% and 12,3%, resp. (both p<0,05).
Conclusion. Pulmonary hypertension syndrome in most cases is present in patients with either idiopathic or RV DCMP. Additional prescription of sildenafil contributes to the decrease of heart failure and respiratory failure severity symptoms and to improvement of hemodynamical signs, leading to significant decrease of systolic pressure in pulmonary artery.
About the Authors
T. A. Abdullaev
Republic Specialized Center for Cardiology. Tashkent, Uzbekistan
Uzbekistan
Uzbekistan
Ya. R. Akhmatov
Republic Specialized Center for Cardiology. Tashkent, Uzbekistan
Uzbekistan
Uzbekistan
R. Sh. Bekbulatova
Republic Specialized Center for Cardiology. Tashkent, Uzbekistan
Uzbekistan
Uzbekistan
N. P. Ganieva
Republic Specialized Center for Cardiology. Tashkent, Uzbekistan
Uzbekistan
Uzbekistan
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Abdullaev T.A., Akhmatov Ya.R., Bekbulatova R.Sh., Ganieva N.P. Pulmonary hypertension syndrome in dilation cardiomyopathy patients: sildenafil application to common treatment of chronic heart failure. Cardiovascular Therapy and Prevention. 2016;15(1):51-57. (In Russ.) https://doi.org/10.15829/1728-8800-2016-1-51-57
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