Sildenafil Improves Cardiac Performance in Patients With Heart Failure
NEW YORK (Reuters Health) Dec 08 - Treatment with the erectile dysfunction drug sildenafil (Viagra) improves cardiac performance in patients with systolic heart failure by decreasing left ventricular (LV) load, an Australian research team reports.
Guidelines currently restrict the use of sildenafil by patients with heart failure, Dr. Michael F. O’Rourke and his associates note in their report, published in the American Journal of Cardiology for November. However, recent studies have suggested that the drug may be safe for those with mild to moderate heart failure.
To further explore the effects of sildenafil on this population, the research team, based at the University of New South Wales in Sydney, enrolled 20 patients with heart failure and with LV fractions < 35%. Nitrates and other vasoactive drugs were withdrawn for at least 12 hours before each session. Subjects took sildenafil 50 mg or placebo in a randomized, 2-way crossover fashion.
Measurements taken between 60 and 180 minutes after treatment showed that heart rate decreased by 4.1 beats/min after sildenafil was taken. The cardiac index response was significantly increased by sildenafil by 0.35 to 0.38 L/min/m.
The authors also observed significant decreases in three components of LV afterload after sildenafil treatment - peripheral resistance, aortic and large artery stiffness, and wave reflection from peripheral sites.
"Our findings, added to others, increase confidence in using sildenafil in patients with erectile dysfunction and heart failure," Dr. O’Rourke and his associates maintain. However, they qualify this advice by noting that there remains a small risk among these patients for sudden death during sexual intercourse or other unaccustomed exertion.
Am J Cardiol 2005;96:1436-1440.
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