Effects of phosphodiesterase type 5 inhibition on systemic and pulmonary hemodynamics and ventricular function in patients with severe symptomatic aortic stenosis

Brian R. Lindman, Alan Zajarias, Jose Madrazo, Jay Shah, Brian F. Gage, Eric Novak, Stephanie N. Johnson, Murali M. Chakinala, Tara A. Hohn, Mohammed Saghir, Douglas L. Mann

Research output: Contribution to journalArticle

Abstract

Background-Pressure overload resulting from aortic stenosis causes maladaptive ventricular and vascular remodeling that can lead to pulmonary hypertension, heart failure symptoms, and adverse outcomes. Retarding or reversing this maladaptive remodeling and its unfavorable hemodynamic consequences has the potential to improve morbidity and mortality. Preclinical models of pressure overload have shown that phosphodiesterase type 5 inhibition is beneficial; however, the use of phosphodiesterase type 5 inhibitors in patients with aortic stenosis is controversial because of concerns about vasodilation and hypotension. Methods and Results-We evaluated the safety and hemodynamic response of 20 subjects with severe symptomatic aortic stenosis (mean aortic valve area, 0.7±0.2 cm 2; ejection fraction, 60±14%) who received a single oral dose of sildenafil (40 or 80 mg). Compared with baseline, after 60 minutes, sildenafil reduced systemic (-12%; P

Original languageEnglish (US)
Pages (from-to)2353-2362
Number of pages10
JournalCirculation
Volume125
Issue number19
DOIs
StatePublished - May 15 2012
Externally publishedYes

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Type 5 Cyclic Nucleotide Phosphodiesterases
Ventricular Function
Aortic Valve Stenosis
Hemodynamics
Lung
Phosphodiesterase 5 Inhibitors
Pressure
Ventricular Remodeling
Aortic Valve
Pulmonary Hypertension
Vasodilation
Hypotension
Heart Failure
Morbidity
Safety
Mortality
Sildenafil Citrate

Keywords

  • aortic valve stenosis
  • heart failure
  • hemodynamics
  • hypertension, pulmonary
  • phosphodiesterase inhibitors

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of phosphodiesterase type 5 inhibition on systemic and pulmonary hemodynamics and ventricular function in patients with severe symptomatic aortic stenosis. / Lindman, Brian R.; Zajarias, Alan; Madrazo, Jose; Shah, Jay; Gage, Brian F.; Novak, Eric; Johnson, Stephanie N.; Chakinala, Murali M.; Hohn, Tara A.; Saghir, Mohammed; Mann, Douglas L.

In: Circulation, Vol. 125, No. 19, 15.05.2012, p. 2353-2362.

Research output: Contribution to journalArticle

Lindman, BR, Zajarias, A, Madrazo, J, Shah, J, Gage, BF, Novak, E, Johnson, SN, Chakinala, MM, Hohn, TA, Saghir, M & Mann, DL 2012, 'Effects of phosphodiesterase type 5 inhibition on systemic and pulmonary hemodynamics and ventricular function in patients with severe symptomatic aortic stenosis', Circulation, vol. 125, no. 19, pp. 2353-2362. https://doi.org/10.1161/CIRCULATIONAHA.111.081125
Lindman, Brian R. ; Zajarias, Alan ; Madrazo, Jose ; Shah, Jay ; Gage, Brian F. ; Novak, Eric ; Johnson, Stephanie N. ; Chakinala, Murali M. ; Hohn, Tara A. ; Saghir, Mohammed ; Mann, Douglas L. / Effects of phosphodiesterase type 5 inhibition on systemic and pulmonary hemodynamics and ventricular function in patients with severe symptomatic aortic stenosis. In: Circulation. 2012 ; Vol. 125, No. 19. pp. 2353-2362.
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