Echocardiographic assessment of sildenafil’s effectiveness in heart failure and pulmonary hypertension

Abstract

Introduction: Echocardiography is a key diagnostic tool for detecting pulmonary hypertension in heart failure. Sildenafil is indicated in this context; however, its impact is still uncertain. Objectives: To evaluate the effectiveness of sildenafil in patients with reduced left ventricular ejection fraction (LVEF), heart failure and pulmonary hypertension by echocardiography. Methods: A therapeutic evaluation study was performed in 27 patients with symptoms of
heart failure and LVEF≤40%, who had echocardiographic signs of pulmonary hypertension. Out of the 27 patients, 20 had adherence to the drug and 7 did not; these two groups were analyzed by clinical, laboratory and echocardiographic variables. The echocardiographic variables of pulmonary
hemodynamics were evaluated at the time of indicating sildenafil and twelve weeks later. Follow-up was performed to look for the occurrence of cardiovascular adverse events. A multivariate analysis and a Kaplan-Meier survival curve were performed. The statistical significance level was p<0.05. Results: an improvement in pulmonary pressures was evident in echocardiogram after the use of sildenafil in the group of patients who adhered to the drug compared to those who did not, systolic pressure 41.25±13.94 vs 61.57±12.08 mmHg, p=0.002; mean pressure 29.42±7.36 vs 40.00±4.04 mmHg, p=0.001; diastolic pressure 16.90±5.04 vs 28.43±6.32 mmHg, p=0.0001. Adverse event-free survival was higher in the group that adhered to the drug HR=0.002; p=0.002. Conclusions: Sildenafil was effective in improving the hemodynamic profile, and those who adhered to
it had better survival.