Phosphodiesterase-5 Inhibitor in Eisenmenger Syndrome

Abstract

Background-Phosphodiesterase-5 inhibitors produce a significant decrease in pulmonary vascular resistance in patients with idiopathic pulmonary arterial hypertension. We studied the effects of tadalafil, a phosphodiesterase-5 inhibitor, on short-term hemodynamics, tolerability, and efficacy over a 12-week period in patients of Eisenmenger syndrome having a pulmonary vascular pathology similar to idiopathic pulmonary arterial hypertension. Methods and Results-Sixteen symptomatic Eisenmenger syndrome patients (mean age, 25Ϯ8.9 years) were assessed hemodynamically at baseline and 90 minutes after a single dose of tadalafil (1 mg/kg body weight up to a maximum of 40 mg). The same dose was then continued daily for 12 weeks, and the patients were restudied.

The challenge of managing pulmonary arterial hypertension in adults with congenital heart disease

“…The authors were able to demonstrate significant improvements in pulmonary hemodynamics (including PVR and mean pulmonary arterial pressure) as well as in symptoms, peripheral oxygen saturations and 6MWD. In addition, Mukhopadhyay et al [64] reported data from 16 ES patients that showed that tadalafil reduces pulmonary vascular PVR, mean pulmonary arterial pressure and improves peripheral oxygen saturation after 12 weeks of therapy.…”

Hipertensión arterial pulmonar (síndrome de Eisenmenger) en el embarazo. Presentación de caso

“…Aunque el nivel de evidencia del uso de sildenafil sea menor que el del Bosentan (no hay estudios controlados aleatorizados para sildenafil) éste tiene una especial consideración en su uso, especialmente si no existe disponibilidad de Bosentan en el contexto de la paciente, tal como ocurrió en este caso. (24,(25)(26)(27)(28)(29)(30). El Sildenafil ha demostrado mejoría en: parámetros hemodinámicos, capacidad de ejercicio, índice de disnea de Borg, clase funcional, calidad de vida y buena tolerancia.…”

Pulmonary Hypertension in Congenital Shunts

“…56 These findings are supported by other small studies of PDE-5 inhibitors, alone and in combination with prostanoids, which also showed improvements in exercise capacity, functional class and some hemodynamic parameters without safety issues. [57][58][59][60] Recently, Tay et al showed that 3 months sildenafil was well tolerated in 12 adult ES and associated with a significant improvement in quality of life and exercise capacity. 61 Results with regard to efficacy, although encouraging, need validation in large randomised, placebo-controlled trials.…”