Long-Term Use of Sildenafil in the Therapeutic Management of Heart Failure
Marco Guazzi, MD, PhD, FACC*,*,
Michele Samaja, PhD ,
Ross Arena, PhD ,
Marco Vicenzi, MD* and
Maurizio D. Guazzi, MD, PhD, FESC
* Cardiopulmonary Unit, Cardiology Division, University of Milan, San Paolo Hospital, Milan, Italy
Biochemistry Department, University of Milan, San Paolo Hospital, Milan, Italy
Virginia Commonwealth University, Richmond, Virginia
Institute of Cardiology, University of Milan, Milan, Italy.
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Figure 1 Study Design
Measurements at day –2 were performed at baseline, and those at day –1 were performed after a single oral dose of sildenafil (50 mg) in all participants. CHF = chronic heart failure; CPET = cardiopulmonary exercise testing.
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Figure 2 Ergoreflex Assessment
Graphic expression of ventilation (VE) at rest (2 min), during handgrip (5 min), and during recovery (3 min) of metaboreflex test, in the baseline and after 3- and 6-month treatment in patients receiving placebo and in patients receiving sildenafil. *p < 0.01 versus no occlusion. p < 0.01 versus patients receiving placebo.
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Figure 3 Correlation Analyses
Correlation analyses between brachial artery flow-mediated dilatation (FMD) and the ergoreflex component of the ventilatory response to handgrip at baseline in the placebo group (solid triangles) and in the sildenafil group (open triangles) as well as between changes of the 2 variables at 3- (open circles) and 6-month (solid circles) treatment. VE = ventilation.
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Figure 4 Correlation Analyses
Correlation analyses between changes from baseline in the ergoreflex component of the ventilatory response to handgrip and those in VE/VCO
2 slope and peak oxygen uptake (VO
2) in the placebo and sildenafil groups at 3- (open circles) and 6-month (solid circles) treatment. VCO
2 = carbon dioxide production; VE = ventilation.
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