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首页> 外文期刊>Pulmonary pharmacology & therapeutics >Acute effects of sildenafil on exercise pulmonary hemodynamics and capacity in patients with COPD.
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Acute effects of sildenafil on exercise pulmonary hemodynamics and capacity in patients with COPD.

机译：西地那非对COPD患者运动肺血流动力学和容量的急性影响。

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BACKGROUND: We investigated in chronic obstructive pulmonary disease (COPD) patients whether a single dose of sildenafil can attenuate the exercise-induced increase in pulmonary artery pressure, thereby allowing augmentation of stroke volume (SV), and improving maximal exercise capacity. METHODS: Eighteen COPD patients (GOLD II-IV) underwent right heart catheterization at rest and submaximal exercise. Mean pulmonary artery pressure (mPpa) and cardiac output (CO) were assessed. Resting and exercise measurements were repeated 60min after oral intake of 50mg sildenafil. Also, on different days, patients performed two maximal exercise tests (CPET) randomly, 1h after placebo and after 50mg sildenafil. RESULTS: Five COPD patients had pulmonary hypertension (PH) at rest (mPpa >25mmHg) and six developed PH during exercise (mPpa >30mmHg). In all patients, mPpa increased from rest to submaximal exercise (23+/-10-35+/-14mmHg). After sildenafil mPpa at rest was 20+/-10mmHg, in exercise mPpa was increased less to 30+/-14mmHg (p<0.01). The reduced augmentation in mPpa was not accompanied by an increased SV and CO. In COPD patients with PH the percentage increase in mPpa to submaximal exercise was 68% before, and 51% after oral intake of sildenafil (p=0.07). In COPD without PH, these values were 46% and 41% (ns), respectively. Maximal exercise capacity and CPET characteristics were unchanged after sildenafil. CONCLUSION: Regardless of mPpa at rest, sildenafil attenuates the increase in mPpa during submaximal exercise in COPD. This attenuated increase is neither accompanied by enhanced SV and CO, nor by improved maximal exercise capacity.
机译：背景：我们研究了慢性阻塞性肺疾病（COPD）患者，单剂量西地那非是否能够减轻运动引起的肺动脉压升高，从而增加中风量（SV）并改善最大运动能力。方法：18名COPD患者（GOLD II-IV）在休息和次最大运动量时进行了右心导管检查。评估平均肺动脉压（mPpa）和心输出量（CO）。口服50mg西地那非60分钟后重复休息和运动。同样，在不同的日子，患者在安慰剂后1h和西地那非50mg后随机进行两次最大运动试验（CPET）。结果：5例COPD患者在休息时出现肺动脉高压（mPpa> 25mmHg），6例在运动期间出现肺动脉高压（mPpa> 30mmHg）。在所有患者中，mPpa从休息到次最大运动量均增加（23 +/- 10-35 +/- 14mmHg）。西地那非静息mPpa在20 +/- 10mmHg之后，在运动中mPpa减少到30 +/- 14mmHg（p <0.01）。降低mPpa的增加并不会伴随SV和CO的增加。在患有PH的COPD患者中，口服西地那非之前，低于最大运动量的mPpa的增加百分比为68％，之后为51％（p = 0.07）。在没有PH的COPD中，这些值分别为46％和41％（ns）。西地那非治疗后的最大运动能力和CPET特征未改变。结论：无论静息状态下的mPpa多少，西地那非都会减弱COPD亚最大运动过程中mPpa的增加。这种减弱的增加既不伴有SV和CO增强，也没有伴有最大运动能力的改善。

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