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Revista Médica Electrónica

On-line version ISSN 1684-1824

Abstract

FERNANDEZ MESA, José Enrique  and  DIAZ VAZQUEZ, Elizabeth. Treatment with sildenafil in left ventricular dysfunction and associated pulmonary hypertension. Rev.Med.Electrón. [online]. 2021, vol.43, n.5, pp. 1345-1359.  Epub Oct 31, 2021. ISSN 1684-1824.

Introduction:

pulmonary hypertension is a common finding in heart failure. The use of sildenafil in these cases is a common practice, but still controversial due to the limited number of studies carried out.

Objective:

to compare echocardiographic variables of pulmonary hemodynamics, in patients with left ventricular systolic dysfunction and severe secondary pulmonary hypertension, before and after the use of sildenafil.

Materials and methods:

a cohort study was led, including 19 patients; a two-year follow-up was carried out. Clinical, laboratory and echocardiographic variables were analyzed. The main pulmonary hemodynamics variables were evaluated before the use of sildenafil and 12 weeks after its indication. A survival curve was performed at the end of the follow-up. The statistical significance level used was p < 0.05.

Results:

the average age was 56.16 ± 15.77 years, and male sex predominated with 73.3 %. Survival at the end of the follow up was 78.9 %. The main echocardiographic variables of pulmonary hemodinamics showed a significant reduction at 12 weeks of treatment with sildenafil. The survival of patients with a 25 % reduction in pulmonary pressures in the echocardiogram performed at 12 weeks of treatment was greater at the end of the study (100 % vs 33 %, log-rank test p = 0.001).

Conclusions:

after using sildenafil, a significant reduction of pulmonary hemodynamics variables was found in the evolutionary echocardiogram. Survival was higher in patients who had this reduction.

Keywords : pulmonary hypertension; left systolic ventricular disfunction; sildenafil.

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