%0 Journal Article
%T Impacto do sildenafil sublingual na hipertens£¿o pulmonar de pacientes com insufici¨ºncia card¨ªaca
%A Freitas Jr.
%A Aguinaldo Figueiredo de
%A Bacal
%A Fernando
%A Oliveira Jr.
%A Jos¨¦ de Lima
%A Santos
%A Ronaldo Honorato Barros
%A Moreira
%A Luiz Felipe Pinho
%A Silva
%A Christiano Pereira
%A Mangini
%A Sandrigo
%A Carneiro
%A Rodrigo Moreno Dias
%A Fiorelli
%A Alfredo In¨¢cio
%A Bocchi
%A Edimar Alcides
%J Arquivos Brasileiros de Cardiologia
%D 2009
%I Sociedade Brasileira de Cardiologia - SBC
%R 10.1590/S0066-782X2009000200008
%X background: pulmonary hypertension (ph) is a factor of poor prognosis in the postoperative period of heart transplant (ht) and thus, the study of the degree of reversibility to vasodilators is mandatory during the preoperative assessment. objective: to evaluate the pulmonary and systemic hemodynamic effects of sildenafil as a vasodilator during the ph reversibility test in patients that are candidates to ht. methods: patients awaiting ht were submitted to the measurement of systemic and pulmonary hemodynamic variables before and after the administration of a single sublingual dose of 100 mg of sildenafil during right heart catheterization. results: fourteen patients (age: 47¡À12 years, 71.4% men) with advanced heart failure ejection fraction (ef) 25 ¡À 7%, functional class (fc - nyha) fc iii - 6 and fc iv - 8, were evaluated in this study. the acute administration of sildenafil showed to be effective in decreasing the systolic (62.4 ¡À 12.1 vs 51.5 ¡À 9.6 mmhg, ci=95%, p<0.05) and mean (40.7 ¡À 7.3 vs 33.8 ¡À 7.6 mmhg, ci=95%, p <0.05) pressures of the pulmonary artery. there was also a significant decrease in the pulmonary (4.2 ¡À 3 vs 2.0 ¡À 0.9 uwood, ci=95%, p<0.05) and systemic vascular resistance (22.9 ¡À 6.8 vs 18.6 ¡À 4.1 wood, ci=95%, p<0.05), associated to an increase in the cardiac output (3.28 ¡À 0.79 vs 4.12 ¡À1.12 uwood, ci=95%, p<0.05) without, however, significantly interfering in the systemic arterial pressure (87.8 ¡À 8.2 vs 83.6 ¡À 9.1 mmhg, ci=95%, p=0.3). conclusion:the sublingual administration of sildenafil is an effective and safe alternative as a vasodilator during the ph reversibility test in patients with heart failure and awaiting a ht.
%K vasodilatator agents
%K hypertension
%K pulmonary
%K heart failure.
%U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0066-782X2009000200008&lng=en&nrm=iso&tlng=en