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Sildenafil Achieved Hemodynamic Improvements in Patients with Inoperable WHO Class II/III Chronic Thromboembolic Pulmonary Hypertension

Yuichi Tamura

Masaharu Kataoka

Takashi Kawakami

K. Fukuda

Toru Satoh

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Conference: 2010 International PHA Conference and Scientific Sessions

Release Date: 06.24.2010

Presentation Type: Abstracts

Tamura Y, Kataoka M, Kawakami T, Fukuda K, Satoh T. 
Keio University School of Medicine, Japan

BACKGROUNDChronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease with poor prognosis. Although thromboendarterectomy is an effective treatment modality for CTEPH, medical options are extremely limited in inoperable cases. Recently, oral agents such as bosentan and sidenafil became available and we sought to compare their impact on hemodynamic variables in this condition.

METHODSWe enrolled sixteen Japanese inoperable CTEPH patients in WHO functional class II and III who had never taken bosentan or sildenafil previously. Seven patients took bosentan initially, and the other 9 took sildenafil. Systolic pulmonary artery pressure (sPAP) was measured via right heart catheter examination or echocardiogram. Plasma BNP levels were also followed.

RESULTSThe mean following period was 5.7 and 4.0 months in the bosentan and sildenafil group, respectively. Baseline hemodynamic data did not differ significantly between the two groups and both treatments were well tolerated. In the bosentan group, sPAP achieved no significant improvements compared to the baseline values. In contrast, a statistically significant benefit (-17.4% of baseline; p<0.05) of sildenafil on sPAP was demonstrated. Plasma BNP level remained unchanged in both groups.

CONCLUSIONSThese results demonstrated a positive treatment effect of sildenafil on hemodynamical variable in CTEPH. Further trials are needed to define the role of sildenafil therapy in Japanese patients with CTEPH.

Figure: Changes of the systolic PAP in each groups

Sildenafil Achieved Hemodynamic Improvements in Patients with Inoperable WHO Class II/III Chronic Th