Effect of sildenafil on pulmonary hypertension associated with left heart failure

This study aims to evaluate the effect of sildenafil on pulmonary hypertension (PH) associated with chronic left heart failure. Twenty patients with PH and left heart failure were divided into treatment group (10 cases, with an oral dose of sildenafil 75 mg daily for 8 weeks) and control group (10 cases, with treatment of cardiac glycosides, diuretics, angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker and beta-blockers). Left ventricular systolic function (LVEF), the pulmonary artery systolic pressure (PH), the left ventricular fraction shortening (LVFS), the left atrium diameter (LAD) and the left ventricular end-diastolic diameter (LVD) were measured by echocardiography, the left ventricular mass index (LVMI) was also calculated. The level of N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected by electrochemiluminescence and high sensitivity C-reactive protein (hsCRP) by immune transmission. The walking distance in 6-minute walk test (6-MWT) was calculated. Before treatment, there were no significant differences in LVEF, LVFS, NT–proBNP, hsCRP, 6-MWT, LVD, LAD and LVMI between the treatment group and control group. After four weeks intervention in the treatment group, LVEF, FS and 6-MWT were significantly increased, while NT–proBNP, hsCRP, 6-MWT, LVD and LVMI were significantly decreased, when compared with the control group. In conclusion, sildenafil can improve cardiac function and reduce pulmonary artery pressure. In addition, it can attenuate myocardial remodeling through its anti-inflammatory effect.