Effect of Short-Term Oral Sildenafil Treatment in Primary Pulmonary Hypertension

Primary pulmonary lıype rlemion ( PPH) isa disease wir/ı a poor prognosis w il h 110 effective treatment. Sildenafil. a se/ecrive phosp/ıodiesterasf!;-5 enzy11ıe inhibilor. awses ptt!monary vasodilatalion by increasing eyetic guanosine monoplıosplı ate /eve/s. In order lo investigcue 1/ıe effecl and safely of slıorl-temı orallı iglı-dose sildenafil treatment on hemodynamic pammeters in patienls wilh PPH. 8 parients were given sildelıafil ata dose of 200 mg/day (50 mg q.i .d) for 3 days. Righr m ıd le.flhearl catlıeterizaıion was performed be.fore lrea/ment and 1 h oıır af/er the lm'f dose of si/denafil. No significant change in mean systemic arterial blood pressııre (90±9 mmHg. pre-treatmetl/; 88±7 mmHg. post-lreatment; p=0./25) was obserl'ed wilh a sigtıificant decrease inmeatı pulmonary artery pressure (60±1/mmHg. pre-treaunellf; 54±14mmHg. post-tremment; p=0.008). No s ide effect reqııiring withdrawa/ oj si/denafil was observed. Wlıen palients were eva/uated indiviclııally. tlıe decrease inmean pulmonary artery pressure ıvas over 20% in 2 patients. benveen 5 and /0% in 2 patiellfs and belo ıv 5% in 4 patienls. Thus. sildena.fil treatmeni decreased meatı pu/monary artery pressure by a selective vasodilatory effect on pttlmonary vascu/ar bed in patients ıvitlı PPH. Nonetheless. this effect is variable among patients.