5型固酶抑制对严重症状性大动脉狭窄症患者的全身和肺血液动力学以及心室功能的影响
Brian R Lindman1, Alan Zajarias, José A Madrazo
1Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. blindman@dom.wustl.edu
Circulation
|March 27, 2012
概括
用西尔德纳菲尔抑制固酶5型可以安全地改善严重大动脉狭窄患者的血液动力学,减少肺和全身抵抗. 这支持进一步研究其作为对大动脉狭窄的辅助疗法的使用.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 大动脉狭窄导致不适应性重塑,导致肺高血压和心力衰竭.
- 临床前研究表明,固酶5型 (PDE5) 抑制剂有利于压力过载,但由于低血压的担忧,主动脉狭窄的临床使用仍在争论中.
研究的目的:
- 为了评估单次口服西尔德纳菲尔剂量的安全性和血液动力学影响,在患有严重症状大动脉狭窄症的患者.
主要方法:
- 20名患有严重症状性大动脉狭窄症的患者接受了单次口服西尔代纳菲尔剂量 (40或80毫克).
- 血液动力学参数包括血管阻力,压力,服从性和中风体积指数在药物服药前后被测量.
主要成果:
- 西尔德纳菲尔显著降低了全身和肺血管阻力以及肺动脉和压的平均值.
- 血管合规性和中风体积指数在西尔德纳菲尔给药后显著增加.
- 血液动力学变化并不依赖于剂量,药物耐受性良好,没有症状的低血压.
结论:
- 一次剂量PDE5抑制剂 (西尔德纳菲尔) 是安全的,并且在严重的大动脉狭窄患者中耐受良好.
- 西尔德纳菲尔改善了肺和全身血液动力学,导致双心室卸载.
- 这些发现支持进一步长期研究PDE5抑制作为主动脉狭窄症的辅助疗法.
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