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Sildenafil improved echocardiographic measures of heart function in young patients
Children and young adult survivors of single-ventricle heart disease palliation who were prescribed sildenafil experienced significant improvements in echocardiographic measures of heart function.
Researchers enrolled 27 children and young adults (mean age, 14.9 years) an average of 11 years after a Fontan operation. Patients were randomly assigned to sildenafil 20 mg (Viagra, Pfizer) or placebo for 6 weeks after a baseline screening assessment. After a 6-week washout period, patients switched treatments for an additional 6 weeks, and underwent echocardiographic evaluation at the beginning and end of each phase.
Study results showed improvement in the myocardial performance index (–0.051; 95% CI, –0.095 to –0.0077) and the product of the velocity time integral of the dominant outflow tract and the heart rate (11 cm x beats/min; 95% CI, 7.5-220) after treatment with sildenafil. Researchers found no change in the measures of inflow velocities, myocardial velocities and the ratio of blood pool velocity to myocardial velocity during passive inflow.
The researchers concluded that “an evaluation of sildenafil over a longer duration of time and in a larger cohort is needed to determine if [these] findings are maintained beyond 6 weeks, if there is a morphology specific effect, if long-term administration of sildenafil is safe, and if the changes in ventricular performance are associated with improvements in functional capacity and quality of life.
“However, for a disease in which no long-term medical management has been shown to be effective, this study provides an early indication that phosphodiesterase E5 inhibition might improve ventricular performance and help to avoid some of the complications seen with single ventricle physiology late after the Fontan operation,” they wrote in the study.
Disclosure: The researchers report no relevant financial disclosures.