title: Sildenafil improves endothelial function in patients with pulmonary hypertension.
abstract: BACKGROUND
  Sildenafil has been shown to be effective in the treatment of pulmonary hypertension, and has favourable effects on endothelial function. Our hypothesis is that a part of the beneficial effects of sildenafil in patients with pulmonary hypertension is due to the improvement of the endothelial function.
  
  
  METHODS
  Nine patients (seven females, age 67+/-9 years) with thromboembolic pulmonary hypertension were treated with sildenafil, at a mean dose of 150+/-75 mg/die. At baseline and after 6 months all patients underwent: right-heart catheterization, 6-min walking distance, and a study of endothelial function, including the measure of the flow-mediated vasodilation of the brachial artery, and the dosage of plasma levels of endothelin-1 and von Willebrand factor.
  
  
  RESULTS
  During follow-up we found a significant reduction of mean pulmonary artery pressure and arteriolar resistances. Accordingly, the functional capacity improved (an average of+37 m). Sildenafil improved endothelial-dependent vasodilation and reduced plasma concentrations of endothelin-1 (from 4.5+/-0.6 to 3.1+/-0.7 pg/mL; p<0.0001) and von Willebrand factor (from 183.1+/-10.1 to 149.1+/-17.6 mU/mL; p<0.0001).
  
  
  CONCLUSIONS
  Improvement of the endothelial function may represents one of the mechanisms able to explain the favourable effects sildenafil has shown in patients with pulmonary hypertension.
authors.affiliation: Institute of Cardiology, Policlinico Hospital, University of Modena and Reggio Emilia, Via del pozzo, 71. 41100 Modena, Italy. rossi.rosario@unimore.it <rossi.rosario@unimore.it>
authors.forename: Rosario
authors.initials: R
authors.lastname: Rossi
authors.forename: Annachiara
authors.initials: A
authors.lastname: Nuzzo
authors.forename: Antonella
authors.initials: A
authors.lastname: Lattanzi
authors.forename: Francesca
authors.initials: F
authors.lastname: Coppi
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Modena
mesh_terms: D000368:Aged; D001916:Brachial Artery / Q000503:physiopathology; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate