Additional use of a phosphodiesterase 5 inhibitor in patients with pulmonary hypertension secondary to chronic systolic heart failure
作者单位：Cardiovascular Department of Xinqiao HospitalThird Military Medical University
会议名称：《中国微循环学会2014年全国学术会议》
会议日期：2014年
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
关 键 词：Chronic heart failure pulmonary hypertension left heart disease phosphodiesterase type 5 inhibitor meta-analysis
摘 要：Aims:Increased indiscriminate use of pulmonary artery hypertension targeted drugs has been observed in patients with pulmonary hypertension(PH)secondary to heart *** performed a meta-analysis to evaluate the chronic effects of using phosphodiesterase 5(PDE5)inhibitors to treat patients with PH secondary to chronic systolic heart *** and Results:PubMed,EMBASE,and the Cochrane Library were searched through October 2013 for randomized controlled trials(RCTs)assessing PDE5inhibitor treatments in PH patients secondary to chronic heart *** RCTs involving 206 chronic systolic heart failure patients with PH complications were *** was used in all *** treatment resulted in fewer hospital admissions compared with the placebo treatment(3.15%versus 12.20%;risk ratio,0.29;95%confidence interval,0.11-0.77).Various hemodynamic parameters were improved with additional sildenafil treatment,including reduced mean pulmonary artery pressure(weighted mean differences,[WMD],-5.71 mmHg,p0.05),and pulmonary vascular resistance(WMD,-81.5 dynes/cm-5,p0.00001),increased left ventricular ejection fraction(WMD,3.95%,p0.001),and unchanged heart rate and blood *** exercise capacity improved(Oxygen consumption at peak exercise,WMD,3.20 ml/min-1/kg-1,p0.00001;Ventilation to CO2production slope,WMD,-5.89,p0.00001),and the clinical symptoms were relieved based on the breathlessness(WMD,7.72,p0.00001),fatigue(WMD,2.28,p0.05),and emotional functioning(WMD,5.92,p0.00001)***:Additional sildenafil treatment is a potential therapeutic method to improve pulmonary exercise capacity and quality of life by ameliorating PH in patients with chronic systolic heart failure.