西地那非对先天性心脏病相关的阻力型肺动脉高压患者远期右心功能及活动耐量的影响Effects of sildenafil on long-term right heart function and exercise tolerance in patients with resistance pulmonary arterial hypertension associated with congenital heart disease
谭洪文;潘裕佳;杜发旺;张萍;罗依然;张长海;刘兴会;王纪人;刘晓桥;
TAN Hongwen;PAN Yujia;DU Fawang;ZHANG Ping;LUO Yiran;ZHANG Changhai;LIU Xinghui;WANG Jiren;LIU Xiaoqiao;Department of Cardiology,Guizhou Provincial People's Hospital;
摘要(Abstract):
目的探讨西地那非对先天性心脏病相关的阻力型肺动脉高压患者远期右心功能及活动耐量的影响。方法 84例阻力型先天性心脏病相关动脉高压(PAH-CHD)患者均分为西地那非组(口服西地那非)和对照组(口服贝前列素钠),比较2组患者服药前、服药后6个月及12个月时肺动脉收缩压、三尖瓣反流速度、右室游离壁厚度、世界卫生组织(WHO)功能分级Ⅲ-Ⅳ级、脑钠肽、6 min步行距离(6MWT)及指脉氧饱和度的差异。结果服药后6个月及12个月时,与对照组比较,西地那非组肺动脉压力及三尖瓣反流速度下降差异有明显统计学意义(P<0.01);西地那非组患者服药前、服药后6个月及服药后12个月时的WHO功能分级Ⅲ-Ⅳ级患者的例数减少、BNP水平下降,6MWT逐步提升,差异有统计学意义(P<0.01)。结论西地那非可改善阻力型肺动脉高压患者远期右心功能及活动耐量。
Objective To investigate the effect of sildenafil on long-term right heart function and exercise tolerance in patients with resistant pulmonary arterial hypertension associated with congenital heart disease(PAH-CHD).Methods Eighty-four patients with PAH-CHD were randomly divided into sildenafil group(oral sildenafil alone) and control group(oral beraprost sodium alone).Pulmonary artery systolic blood pressure,tricuspid regurgitation velocity,right ventricular free wall thickness,functional classification Ⅲ-Ⅳ of World Health Organization(WHO),the differences in brain natriuretic peptide,6-min walking distance(6 MWT) and finger pulse oxygen saturation were detected and compared before taking the medicine,6 months and 12 months after taking the medicine.Results At 6 months and 12 months after taking the medicine,pulmonary artery pressure and tricuspid regurgitation velocity were decreased in sildenafil group relative to control group(P <0.01).When compared to control group,sildenafil group had reduced number of patients with WHO functional classification Ⅲ-Ⅳ,decreased BNP level,while 6 MWT gradually were increased(P <0.01).Conclusion Sildenafil can improve long-term right heart function and exercise tolerance in patients with resistant pulmonary hypertension.
关键词(KeyWords):
西地那非;先天性心脏病相关的肺动脉高压;阻力型;右心功能;活动耐量
sildenafil;pulmonary arterial hypertension associated with congenital heart disease(PAH-CHD);resistant type;right heart function;exercise tolerance
基金项目(Foundation): 贵州省卫生厅青年基金项目[gzwkj2009-2-001]
作者(Authors):
谭洪文;潘裕佳;杜发旺;张萍;罗依然;张长海;刘兴会;王纪人;刘晓桥;
TAN Hongwen;PAN Yujia;DU Fawang;ZHANG Ping;LUO Yiran;ZHANG Changhai;LIU Xinghui;WANG Jiren;LIU Xiaoqiao;Department of Cardiology,Guizhou Provincial People's Hospital;
DOI: 10.19367/j.cnki.2096-8388.2021.11.014
参考文献(References):
- [1]朱鲜阳,张端珍.2015年先天性心脏病相关性肺动脉高压诊治中国专家共[J].中国介入心脏病学杂志,2015,23(2):61-69.
- [2] CHAU E M,FAN K Y,CHOW W H. Effects of chronic sildenafil in patients with Eisenmenger syndrome versus idiopathic pulmonary arterial hypertension[J]. Int J Cardiol,2007,120(3):301-305.
- [3] SINGH T P,ROHIT M,GROVER A,et al. A randomized,placebo-controlled,double-blind,crossover study to evaluate the efficacy of oral sildenafil therapy in severe pulmonary artery hypertension[J]. Am Heart J,2006,151(4):e851-e855.
- [4] STEINHORN B S,LOSCALZO J,MICHEL T. Nitroglycerin and Nitric oxide-a rondo of themes in cardiovascular therapeutics[J]. N Engl J Med, 2015, 373(3):277-280.
- [5] BHOGAL S,KHRAISHA O,AL MADANI M,et al. Sildenafil for pulmonary arterial hypertension[J]. Am J Ther,2019,26(4):e520-e526.
- [6] PEPKE-ZABA J,GILBERT C,BROWN M C. Sildenafil improves health-related quality of life in patients with pulmonary arterial hypertension[J]. Chest,2008,133(1):183-189.
- [7] HIDAYATI F,GHARINI P P R,HARTOPO A B,et al.The effect of oral sildenafil therapy on health-related quality of life in adults with pulmonary arterial hypertension related to uncorrected secundum atrial septal defect:a quasi experimental study[J]. Health Qual Life Outcomes,2020,18(1):278.
- [8] BHOGAL S,KHRAISHA O,ALMADANI M,et al. Sildenafil for pulmonary arterial hypertension[J]. Am J Ther,2019,26(4):e520-e526.
- [9] WANG R C,JIANG F M,ZHENG Q L,et al. Efficacy and safety of sildenafil treatment in pulmonary arterial hypertension:a systematic review[J]. Respir Med,2014,108(3):531-537.
- [10]DHARIWAL A K,BAVDEKAR S B. Sildenafil in pediatric pulmonary arterial hypertension[J]. J Postgrad Med,2015,61(3):181-192.
- [11]RAI N,VEEROJU S,SCHYMURA Y,et al. Effect of riociguat and sildenafil on right heart remodeling and function in pressure overload induced model of pulmonary arterial banding[J]. Biomed Res Int,2018,2018:3293584.
- [12]TOXVIG A K,WEHLAND M,GRIMM D,et al. A focus on riociguat in the treatment of pulmonary arterial hypertension[J]. Basic Clin Pharmacol Toxicol, 2019, 125(3):202-214.
- [13]POTOKA K P,WOOD K C,BAUST J J,et al. Nitric oxide-independent soluble guanylate cyclase activation improves vascular function and cardiac remodeling in sickle cell disease[J]. Am J Respir Cell Mol Biol,2018,58(5):636-647.
- [14]BHASIN S,GOGIA P,NAIR R,SAHOO T K. Perioperative sildenafil therapy for children with ventricular septal defects and associated pulmonary hypertension undergoing corrective surgery:A randomised clinical trial[J]. Indian J Anaesth,2017,61(10):798-802.
- [15]MORI H,PARK I S,YAMAGISHI H,et al. Sildenafil reduces pulmonary vascular resistance in single ventricular physiology[J]. Int J Cardiol,2016,221:122-127.
- [16]BELYAVSKIY E,OVCHINNIKOV A,POTEKHINA A,et al. Phosphodiesterase 5 inhibitor sildenafil in patients with heart failure with preserved ejection fraction and combined pre-and postcapillary pulmonary hypertension:a randomized open-label pilot study[J]. BMC Cardiovasc Disord,2020,20(1):408.
- [17]SHRESTHA S K,SRIVASTAVA B,KARKI M,et al.Effect of sildenafil citrate on pulmonary arterial systolic pressure and sub-maximal exercise capacity in chronic obstructive pulmonary disease[J]. Kathmandu Univ Med J(KUMJ),2017,15(60):271-278.
- [18]HAO Y,ZHU Y,MAO Y,et al. Efficacy and safety of Sildenafil treatment in pulmonary hypertension caused by chronic obstructive pulmonary disease:A meta-analysis[J]. Life Sci,2020,257:118001.
- [19]BIGDELIAN H,SEDIGHI M. The role of preoperative sildenafil therapy in controlling of postoperative pulmonary hypertension in children with ventricular septal defects[J]. J Cardiovasc Thorac Res,2017,9(3):179-182.
- [20]PATEL R,THINGNAM S K S,MISHRA A K,et al. Benefits of perioperative sildenafil therapy in children with a ventricular septal defect with pulmonary artery hypertension on early surgical outcomes[J]. J Card Surg,2020,35(12):3302-3309.
文章评论(Comment):
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- 西地那非
- 先天性心脏病相关的肺动脉高压
- 阻力型
- 右心功能
- 活动耐量
sildenafil - pulmonary arterial hypertension associated with congenital heart disease(PAH-CHD)
- resistant type
- right heart function
- exercise tolerance
- 谭洪文
- 潘裕佳
- 杜发旺
- 张萍
- 罗依然
- 张长海
- 刘兴会
- 王纪人
- 刘晓桥
TAN Hongwen- PAN Yujia
- DU Fawang
- ZHANG Ping
- LUO Yiran
- ZHANG Changhai
- LIU Xinghui
- WANG Jiren
- LIU Xiaoqiao
- Department of Cardiology
- Guizhou Provincial People's Hospital
- 谭洪文
- 潘裕佳
- 杜发旺
- 张萍
- 罗依然
- 张长海
- 刘兴会
- 王纪人
- 刘晓桥
TAN Hongwen- PAN Yujia
- DU Fawang
- ZHANG Ping
- LUO Yiran
- ZHANG Changhai
- LIU Xinghui
- WANG Jiren
- LIU Xiaoqiao
- Department of Cardiology
- Guizhou Provincial People's Hospital