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- Title
Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with PDE-5 inhibitors.
- Authors
Zimmermann, Gregor S.; Wulffen, Werner; Huppmann, Patrick; Meis, Tobias; Ihle, Franziska; Geiseler, Jens; Leuchte, Hanno H.; Tufman, Amanda; Behr, Juergen; Neurohr, Claus
- Abstract
Background and objective Interstitial lung diseases ( ILD) are often associated with pulmonary hypertension (PH). This study aimed to evaluate the therapeutic benefit of phosphodiesterase-5 ( PDE-5) inhibitors in pulmonary hypertension secondary to ILD. Methods Patients with ILD and PH were treated with sildenafil or tadalafil. Right heart catheterization was performed before and after a minimum of 3-month treatment. In addition, lung function, 6-min walk distance ( 6MWD) and plasma brain natriuretic peptide ( BNP) concentration were assessed. Results Ten ILD patients (three female, mean age 64.4 ± 9.0 years, six with idiopathic pulmonary fibrosis ( IPF), four with hypersensitivity pneumonitis, ( HP)) with significant precapillary PH (mean pulmonary artery pressure ( PAPm) ≥ 25 mmHg, pulmonary vascular resistance ( PVR) > 280 dyn*s*cm−5; pulmonary artery wedge pressure ( PAWPm) ≤ 15 mmHg) were treated with either sildenafil ( n = 5) or tadalafil ( n = 5). Pulmonary haemodynamics were severely impaired at baseline ( PAPm 42.9 ± 5.4 mmHg; cardiac index ( CI) 2.7 ± 0.6 L/min/m2; PVR 519 ± 131 dyn × sec × cm−5). After mean follow-up of 6.9 ± 5.8 months an increase in CI (2.9 ± 0.7 L/min/m2, P = 0.04) and a decrease in PVR (403 ± 190 dyn × sec × cm−5, P = 0.03) were observed. 6MWD and BNP did not change significantly. Conclusions Our data suggest that treatment with PDE-5 inhibitors improves pulmonary haemodynamic patients with PH secondary to ILD.
- Subjects
INTERSTITIAL lung diseases; PULMONARY hypertension; IDIOPATHIC pulmonary fibrosis; PHOSPHODIESTERASE inhibitors; LUNG disease treatment
- Publication
Respirology, 2014, Vol 19, Issue 5, p700
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12294