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1539820 
Journal Article 
Impact of Sublingual Sildenafil on Pulmonary Hypertension in Patients with Heart Failure 
Figueiredo de Freitas, A, Jr; Bacal, F; Oliveira, J, Jr; Barros Santos, RH; Pinho Moreira, LF; Silva, CP; Mangini, S; Dias Carneiro, RM; Fiorelli, AI; Bocchi, EA 
2009 
Arquivos Brasileiros de Cardiologia
ISSN: 0066-782X
EISSN: 1678-4170 
92 
122-126 
Pulmonary hypertension (PH) is a factor of poor prognosis
in the postoperative period of heart transplant (HT) and thus, the study of the degree of
reversibility to vasodilators is mandatory during the preoperative assessment. To evaluate the
pulmonary and systemic hemodynamic effects of sildenafil as a vasodilator during the PH
reversibility test in patients that are candidates to HT. Patients awaiting HT were submitted to
the measurement of systemic and pulmonary hemodynamic variables before and after the
administration of a single sublingual dose of 100 mg of sildenafil during right heart
catheterization. Fourteen patients (age: 47 +/- 12 years, 71.4% men) with advanced heart failure
Ejection Fraction (EF) 25 +/- 7%, Functional Class (FC - NYHA) FC III - 6 and FC IV - 8, were
evaluated in this study. The acute administration of sildenafil showed to be effective in
decreasing the systolic (62.4 +/- 12.1 vs. 51.5 +/- 9.6 mmHg, CI=95%, p<0.05) and mean (40.7 +/-
7.3 vs. 33.8 +/- 7.6 mmHg, CI=95%, p <0.05) pressures of the pulmonary artery. There was also a
significant decrease in the pulmonary (4.2 +/- 3 vs. 2.0 +/- 0.9 uWood, CI=95%, p<0.05) and
systemic vascular resistance (22.9 +/- 6.8 vs. 18.6 +/- 4.1 Wood, CI=95 %, p<0.05), associated to
an increase in the cardiac output (3.28 +/- 0.79 vs. 4.12 +/- 1.12 uWood, CI=95%, p<0.05)
without, however, significantly interfering in the systemic arterial pressure (87.8 +/- 8.2 vs.
83.6 +/- 9.1 mmHg, CI=95%, p=0.3). The sublingual administration of sildenafil is an effective
and safe alternative as a vasodilator during the PH reversibility test in patients with heart
failure and awaiting a HT. (Arq Bras Cardiol 2009; 92(2): 116-120) 
Vasodilatator agents; hypertension, pulmonary; heart failure