Effects of Myocardial Phosphodiesterase 5 Inhibitors on the Left Ventricular Function in Patients With Heart Failure: A Randomized Clinical Trial

Abstract

Backgrounds: Myocardial phosphodiesterase 5 (PDE5) inhibitors are documented for use in various<br />disease states. The efficacy of PDE5 inhibitors is less determined in heart failure patients<br />without pulmonary hypertension. The aim of the present study was to evaluate the efficacy of<br />PDE5 inhibitors in heart failure patients without pulmonary hypertension.<br />Method: Seventy-six cases with heart failure were participated in this study. The selection criteria were<br />systolic heart failure according to the New York Heart Association (NYHA) functional<br />classifications I and IV, echocardiographically determined left ventricular ejection fraction less<br />than 50%, and stability for at least 3 months. The participants were randomly divided into case<br />and control groups. Both case and control groups received 50 mg of sildenafil and a placebo for<br />3 months, respectively. Transthoracic echocardiography (TTE) was performed using the<br />Vingmed 800 CSF. All the ejection fraction measurements were done using the Simpson<br />method. Before the initiation of the trial and then 3 months afterward, TTE was obtained from<br />the participants. Changes in the functional class and the left ventricular ejection fraction before<br />and after the trial were assessed and the data were analyzed using SPSS, version 16.<br />Results: In the case group, the ejection fraction after the trial with an average of 41.53 ± 7.53 was<br />considerably more significant than that before the trial with an average of 37.92 ± 6.92<br />(P < 0.001). The findings also showed that sildenafil inhibited PDE5 and the development of<br />the NYHA IV when given for 90 days. As a result, sildenafil significantly improved the left<br />ventricular ejection fraction.<br />Conclusions: PDE5 inhibitors are effective in the treatment of heart failure patients without pulmonary<br />hypertension.