title: Long-term vardenafil therapy improves hemodynamics in patients with pulmonary hypertension.
abstract: The phosphodiesterase-5 (PDE-5) inhibitor, sildenafil, has been reported to produce sustained pulmonary vasodilatation in patients with pulmonary hypertension (PH). Recently, vardenafil, a more potent and selective PDE-5 inhibitor than sildenafil, has been approved for the treatment of erectile dysfunction. However, the long-term effects of oral vardenafil in patients with PH are unknown. We studied five consecutive patients with PH; one with primary pulmonary hypertension, two with chronic pulmonary thromboembolism, one with Eisenmenger syndrome (ventricular septal defect) and one with secondary pulmonary hypertension after a ventricular septal defect closure operation. In an acute hemodynamic trial, vardenafil (5 mg) significantly decreased both the pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR) with an increase in cardiac output. In a chronic hemodynamic trial, the maintenance dose of vardenafil (10 to 15 mg) for 3 months significantly decreased the PVR, but not the SVR, with a 20.7% reduction of the PVR/ SVR ratio. Plasma brain natriuretic peptide (BNP) levels were also significantly decreased after 3 months. This pilot study demonstrates that long-term oral vardenafil therapy may be a safe and effective treatment for patients with PH.
authors.affiliation: Division of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. kaizawa@hsp.md.shinshu-u.ac.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Aizawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanaoka
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kasai
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kogashi
authors.forename: Setsuo
authors.initials: S
authors.lastname: Kumazaki
authors.forename: Jun
authors.initials: J
authors.lastname: Koyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsutsui
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yazaki
authors.forename: Noboru
authors.initials: N
authors.lastname: Watanabe
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Uichi
authors.initials: U
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D013450:Sulfones / Q000627:therapeutic use; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
chemical_list: D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride