title: The immediate effect of sildenafil on right ventricular function in patients with heart failure measured by cardiac magnetic resonance: a randomized control trial.
abstract: BACKGROUND
  Studies have demonstrated that phosphodiesterase 5 (PDE5) inhibition is associated with right ventricle (RV) functional improvement in patients with primary pulmonary hypertension. This study aims to demonstrate the immediate impact of Sildenafil, a PDE5 inhibitor, on RV function, measured by cardiovascular magnetic resonance (CMR), in patients with heart failure (HF).
  
  
  METHODS
  We conducted a randomized double-blind controlled trial.
  
  
  METHODS
  diagnosis of HF functional class I-III; left ventricle ejection fraction < 35%. Patients underwent CMR evaluation and were then equally randomly assigned to either 50 mg of Sildenafil or Placebo groups. One hour following drug administration, they were submitted to a second scan examination.
  
  
  RESULTS
  26 patients were recruited from a tertiary reference center in Brazil and 13 were allocated to each study group. The median age was 61.5 years (50-66.5 years). Except for the increase in RV fractional area change following the administration of sildenafil (Sildenafil [before vs. after]: 34.3 [25.2-43.6]% vs. 42.9 [28.5-46.7]%, p = 0.04; Placebo [before vs. after]: 28.1 [9.2-34.8]% vs. 29.2 [22.5-38.8]%, p = 0.86), there was no statistically significant change in parameters. There was no improvement in left ventricular parameters or in the fractional area change of the pulmonary artery.
  
  
  CONCLUSIONS
  This study demonstrated that a single dose of Sildenafil did not significantly improve RV function as measured by the CMR.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01936350.
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: André Maurício S
authors: AM
authors: Fernandes
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Agnes Carvalho
authors: AC
authors: Andrade
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Natalia Duarte
authors: ND
authors: Barroso
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Igor Carmo
authors: IC
authors: Borges
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Dafne
authors: D
authors: Carvalho-Andrade
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Erenaldo S
authors: ES
authors: Rodrigues Junior
authors: Department of Radiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Libia Castro
authors: LC
authors: Guimarães
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: André Rodrigues
authors: AR
authors: Durães
authors: Department of Radiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Sirlene Mendes
authors: SM
authors: Borges
authors: Department of Cardiology, Hospital Ana Neri, Federal University of Bahia, Bahia, Brazil.
authors: Roque
authors: R
authors: Aras Junior
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000068677:Sildenafil Citrate / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right / Q000187:drug effects*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D000068677:Sildenafil Citrate