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Sildenafil preserves exercise capacity in patients with idiopathic pulmonary fibrosis and right-sided ventricular dysfunction
- Source :
- Chest. 143(6)
- Publication Year :
- 2013
-
Abstract
- Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with pulmonary vasculopathy.The purpose of this study was to determine whether sildenafil improves 6-min walk distance (6MWD) in subjects with IPF and right ventricular dysfunction.The IPFnet, a network of IPF research centers in the United States, conducted a randomized trial examining the effect of sildenafil on 6MWD in patients with advanced IPF, defined by carbon monoxide diffusing capacitylt; 35% predicted. A substudy examined 119 of 180 randomized subjects where echocardiograms were available for independent review by two cardiologists. Right ventricular (RV) hypertrophy (RVH), right ventricular systolic dysfunction (RVSD), and right ventricular systolic pressure (RVSP) were assessed. Multivariable linear regression models estimated the relationship between RV abnormality, sildenafil treatment, and changes in 6MWD, St. George's Respiratory Questionnaire (SGRQ), the EuroQol instrument, and SF-36 Health Survey (SF-36) from enrollment to 12 weeks.The prevalence of RVH and RVSD were 12.8% and 18.6%, respectively. RVSP was measurable in 71 of 119 (60%) subjects; mean RVSP was 42.5 mm Hg. In the subgroup of subjects with RVSD, subjects treated with sildenafil experienced less decrement in 6MWD (99.3 m; P = .01) and greater improvement in SGRQ (13.4 points; P = .005) and EuroQol visual analog scores (17.9 points; P = .04) than subjects receiving placebo. In the subgroup with RVH, sildenafil was not associated with change in 6MWD (P = .13), but was associated with greater relative improvement in SGRQ (14.8 points; P = .02) vs subjects receiving placebo. Sildenafil treatment in those with RVSD and RVH was not associated with change in SF-36.Sildenafil treatment in IPF with RVSD results in better preservation of exercise capacity as compared with placebo. Sildenafil also improves quality of life in subjects with RVH and RVSD.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Sildenafil
Vasodilator Agents
Ventricular Dysfunction, Right
Walking
Critical Care and Intensive Care Medicine
Placebo
Piperazines
Sildenafil Citrate
Statistics, Nonparametric
law.invention
Placebos
Idiopathic pulmonary fibrosis
chemistry.chemical_compound
Randomized controlled trial
Quality of life
Double-Blind Method
law
Internal medicine
Surveys and Questionnaires
medicine
Humans
In patient
Sulfones
Aged
Original Research
Chi-Square Distribution
Hypertrophy, Right Ventricular
business.industry
Exercise capacity
medicine.disease
Idiopathic Pulmonary Fibrosis
respiratory tract diseases
Surgery
Respiratory Function Tests
chemistry
Echocardiography
Purines
cardiovascular system
Cardiology
Quality of Life
Regression Analysis
Female
Cardiology and Cardiovascular Medicine
business
Chi-squared distribution
Subjects
Details
- ISSN :
- 19313543
- Volume :
- 143
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi.dedup.....61b212f5785678ab4c197629a51113c7