title: Sildenafil in Heart failure (SilHF). An investigator-initiated multinational randomized controlled clinical trial: rationale and design.
abstract: OBJECTIVE
  Heart failure (HF) is a major clinical problem and, despite advances in both pharmacological and device therapy, the mortality remains high and quality of life poor. Over the last decade there has been growing interest in using phosphodiesterase-5 (PDE-5) inhibitors in HF associated with group 2 pulmonary hypertension (PH), with benefits reported on pulmonary haemodynamic and functional status in single-centre trials Methods The Sildenafil in Heart Failure (SilHF) trial is a randomized, placebo-controlled multinational trial designed to assess efficacy and tolerability of PDE-5 inhibition with sildenafil (target dose 40 mg three times per day) in 210 patients with HF, New York Heart Association (NYHA) functional class II or III, and evidence of group 2 PH. The co-primary endpoints are patient global assessment and the 6 min walk test. Secondary endpoints include NYHA functional class and the quality of life tools Euro QoL 5D and the Kansas City questionnaire. Patients will be followed up for 6 months.
  
  
  CONCLUSIONS
  The authors hypothesize that PDE-5 inhibition can improve exercise capacity and symptoms with acceptable tolerability in patients with HF and group 2 PH.
authors.affiliation: Stavanger University Hospital, Stavanger, Norway. trond.cooper@gmail.com
authors.forename: Trond J
authors.initials: TJ
authors.lastname: Cooper
authors.forename: Marco
authors.initials: M
authors.lastname: Guazzi
authors.forename: Abdallah
authors.initials: A
authors.lastname: Al-Mohammad
authors.forename: Offer
authors.initials: O
authors.lastname: Amir
authors.forename: Tuvia
authors.initials: T
authors.lastname: Bengal
authors.forename: John G
authors.initials: JG
authors.lastname: Cleland
authors.forename: Kenneth
authors.initials: K
authors.lastname: Dickstein
mesh_terms: D004305:Dose-Response Relationship, Drug; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage; D010879:Piperazines / Q000008:administration & dosage*; D011687:Purines / Q000008:administration & dosage; D011788:Quality of Life; D000068677:Sildenafil Citrate; D013318:Stroke Volume / Q000187:drug effects*; D013450:Sulfones / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate