title: Comparative efficacy of sildenafil in Eisenmenger's syndrome secondary to atrial septal defect versus ventricular septal defect: a cardiac catheterisation follow-up study.
abstract: OBJECTIVE
  This study evaluates the efficacy and safety of sildenafil in patients with Eisenmenger's syndrome with special emphasis on haemodynamic parameters and its comparative efficacy in atrial septal defect versus ventricular septal defect patients.
  
  
  METHODS
  Oral sildenafil was given to 22 patients with Eisenmenger's syndrome - eight with atrial septal defect and 14 with ventricular septal defect - after detailed baseline evaluation including a six-minute walk test, echocardiography, and cardiac catheterisation. Patients were followed up for a period of 6 months for functional class assessment and six-minute walk distance. Cardiac catheterisation was repeated in all patients.
  
  
  RESULTS
  A significant improvement in the World Health Organization functional class, six-minute walk distance, mean pulmonary arterial pressure, and pulmonary vascular resistance was noticed. Systemic arterial and mixed venous oxygen saturations were also significantly improved along with improvement in pulmonary blood flow. None showed any significant side effects or worsening of systemic arterial saturation. At baseline, mean pulmonary arterial pressure, pulmonary vascular resistance, and pulmonary/systemic vascular resistance ratios were significantly higher in ventricular septal defect patients than in atrial septal defect patients. Atrial septal defect patients showed better response in clinical as well as haemodynamic parameters.
  
  
  CONCLUSIONS
  Sildenafil is an effective and safe agent for patients with Eisenmenger's syndrome. It improves their functional capacity as well as haemodynamic parameters. The beneficial effects are greater in patients with Eisenmenger's syndrome secondary to atrial septal defect than ventricular septal defect.
authors: Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. navgarg@sgpgi.ac.in
authors: Naveen
authors: N
authors: Garg
authors: Nishant
authors: N
authors: Tripathy
authors: Nakul
authors: N
authors: Sinha
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D004541:Eisenmenger Complex / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D011687:Purines / Q000008:administration & dosage / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate