Pulmonary hemodynamics and effects of phosphodiesterase type 5 inhibition in heart failure: a meta-analysis of randomized trials

• Published in: BMC cardiovascular disorders 2017-06, Vol.17 (1), p.150-150, Article 150
• Main Authors: Hwang, In-Chang, Kim, Yong-Jin, Park, Jun-Bean, Yoon, Yeonyee E, Lee, Seung-Pyo, Kim, Hyung-Kwan, Cho, Goo-Yeong, Sohn, Dae-Won
• Format: Article
• Language: English
• Subjects: Aged; Arterial Pressure - drug effects; Blood pressure; Cardiovascular agents; Chi-Square Distribution; Chronic obstructive pulmonary disease; Circulatory system; Clinical outcomes; Clinical trials; Comparative analysis; Complications and side effects; Dosage and administration; Drug therapy; Exercise Tolerance - drug effects; Female; Genetic aspects; Heart diseases; Heart failure; Heart Failure - diagnosis; Heart Failure - drug therapy; Heart Failure - physiopathology; Hemodynamics; Hemodynamics - drug effects; Humans; Male; Medical diagnosis; Meta-analysis; Middle Aged; Odds Ratio; Phosphodiesterase; Phosphodiesterase 5 inhibitor; Phosphodiesterase 5 Inhibitors - adverse effects; Phosphodiesterase 5 Inhibitors - therapeutic use; Phosphodiesterases; Physiological aspects; Pulmonary arteries; Pulmonary Artery - drug effects; Pulmonary Artery - physiopathology; Pulmonary Circulation - drug effects; Pulmonary hypertension; Randomized controlled trial; Randomized Controlled Trials as Topic; Recovery of Function; Regression analysis; Rodents; Stroke Volume - drug effects; Studies; Treatment Outcome; Vascular Resistance - drug effects; Ventricular Function, Left - drug effects
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-017-0576-4

Previous studies suggested that phosphodiesterase 5 inhibitors (PDE5i) have a beneficial effect in patients with heart failure (HF), although the results were inconsistent. We performed a meta-analysis to evaluate the effect of PDE5i in HF patients, and investigated the relationship between PDE5i effects and pulmonary hemodynamics. We searched PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) that compared PDE5i with placebo in HF with reduced ejection fraction (HFrEF) or HF with preserved EF (HFpEF). PDE5i effects were interpolated according to baseline pulmonary arterial pressure (PAP) or according to changes in PAP after PDE5i treatment. Thirteen RCTs enrolling 898 HF patients, and two sub-analysis studies with different study outcomes, were included in the meta-analysis. Among patients with HFrEF, PDE5i improved peak VO (mean difference [MD], 3.76 mL/min/kg; 95% confidence interval [CI], 3.27 to 4.25; P