title: Hemodynamic response to sildenafil in patients with decompensated congestive heart failure can be predicted by deceleration time of transmitral flow.
abstract: OBJECTIVE
  How sildenafil acutely provides hemodynamic alterations in patients with decompensated congestive heart failure remains unknown. The aim of this study was to investigate whether myocardial and/or hemodynamic conditions affect hemodynamic response to sildenafil in patients with decompensated heart failure.
  
  
  RESULTS
  Twenty-five consecutive patients with decompensated congestive heart failure were enrolled. The patients underwent echocardiography before and 1 hour after a single oral administration of sildenafil (20 mg). Sildenafil decreased pulmonary vascular resistance by 24% (P < 0.05), and increased left ventricular (LV) time-velocity integral by 17% (P < 0.05). Alteration of the ratio of peak velocity of early LV filling to early diastolic myocardial velocity (E/E'), an indicator of LV filling pressure, following administration of sildenafil, negatively associated with the deceleration time of early filling wave (DcT) at baseline. Patients with baseline DcT ≥ 200 milliseconds (n = 11) exhibited E/E' increase, whereas patients with baseline DcT <200 milliseconds (n = 14) exhibited E/E' decrease.
  
  
  CONCLUSIONS
  Administration of sildenafil elevated LV filling pressure in decompensated heart failure patients with shortened deceleration time of early diastolic transmitral flow.
authors.affiliation: *Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan; and †Department of Internal Medicine, Division of Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morisawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hirotani
authors.forename: Masataka
authors.initials: M
authors.lastname: Sugahara
authors.forename: Miho
authors.initials: M
authors.lastname: Fukui
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ando
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Naito
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Mano
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000494:pharmacology*; D011687:Purines / Q000494:pharmacology; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000494:pharmacology*; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology*; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D010879:Piperazines; D011687:Purines; D013449:Sulfonamides; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate