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Clinical and Hemodynamic Effect of Sildenafil in Patients with Left Sided Heart Failure Complicated with Pulmonary Hypertension

Saud M Elsaughier, Mohamed Kamal Slama, Naggeh M Mahmoud, Ramadan Ghaleb and Elham Abdelmonam

Background: The prognostic role of Pulmonary arterial hypertension (PH) and RV dysfunction in LV HF provides the rationale for targeting PH as a new option in both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). Therefore, we conducted the present randomized controlled trial in order to assess the clinical and hemodynamic effects of sildenafil in patients with left-sided HF complicated with PH.

Methods: The current study enrolled 120 patients who were randomly divided into Sildenafil group included 60 patients received sildenafil therapy in addition to standard treatment of HF and control group included 60 patients received standard treatment of HF only. All patients had left sided HF complicated with severe PH.

Results: Notably, at six months of follow-up, the sildenafil led to statistically significant improvements in the 6 MWT; this improvement was significantly higher in Sildenafil group than control group and patients on sildenafil had a significantly higher frequency of NYHA’s improvement (41(71.9%) vs.16(29.1%); P=0.01) in comparison to the control group. In addition sildenafil led to a higher reduction in mPAP than the control group (p=0.02).

Conclusion: Sildenafil is safe and an effective treatment option for patients with left-sided HF complicated by PH.