scholarly journals Phosphodiesterase-5 Inhibitors Improve Clinical Outcomes, Exercise Capacity and Pulmonary Hemodynamics in Patients With Heart Failure With Reduced Left Ventricular Ejection Fraction: A Meta-Analysis

2017 ◽  
Vol 9 (6) ◽  
pp. 488-498 ◽  
Author(s):  
Renato De Vecchis ◽  
Arturo Cesaro ◽  
Carmelina Ariano ◽  
Anna Giasi ◽  
Carmela Cioppa
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Hemodynamics ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure ◽  
Phosphodiesterase 5

scholarly journals In Chronic Cardiac Decompensation with Reduced Left Ventricular Ejection Fraction, Phosphodiesterase-5 Inhibition Exerts Significant Effects on some Clinical, Functional and Hemodynamic Outcomes: a Meta-Analysis

2017 ◽  
Author(s):  
Renato De Vecchis ◽  
Carmelina Ariano
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Pulmonary Arterial ◽  
Phosphodiesterase 5

Background: In  patients with pulmonary arterial  hypertension, substantial  clinical benefits have been reported with the use of phosphodiesterase-5 inhibitors(PDE5i) . Moreover, some studies would have proven  useful effects  of PDE5i  also  on   the clinical picture of the  pulmonary hypertension(PH) secondary to left-sided chronic heart failure(CHF). Methods: We performed a meta-analysis comprising randomized controlled trials ( RCTs) which had compared  PDE5i ( mostly sildenafil) with  placebo in CHF patients. Results: 14 studies, including 928  patients overall , were admitted to the  meta-analysis. In   heart failure with reduced left ventricular ejection fraction(HFREF), PDE5i,  compared to placebo, significantly improved the composite of death and hospitalization (OR= 0.28; 95% CI: 0.10 to 0.74). They also improved peak VO2  (difference in means[MD]: 3.76; 95% CI: 3.27 to 4.25), six-minutes walk distance ( (6MWD)(  MD, 22.7 meters ; 95% CI, 8.19 to 37.21) and pulmonary arterial systolic pressure (MD: -11.52 mmHg; 95% CI: -15.56 to -7.49). Conversely, in   CHF with preserved left ventricular ejection fraction ( HFpEF), PDE5i  were shown  not to yield  any  beneficial effect  concerning  the investigated endpoints. Conclusions: In HFREF, PDE5i  were shown  to improve  the composite of death and hospitalization, as well as    exercise capacity and pulmonary hemodynamics. Conversely,  in HFpEF, no significant clinical, ergospirometric or hemodynamic  betterment  was achieved  using PDE5i treatment.

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