Sildenafil as adjunct therapy to high-dose epoprostenol in a patient with pulmonary veno-occlusive disease.

Abstract

Pulmonary veno-occlusive disease is refractory to medical treatment and is generally associated with a poor prognosis. Treatment with vasodilators, such as prostacyclin, of patients with PVOD is controversial because of concerns regarding hemodynamic deterioration. Although a preferential pulmonary vasodilatory effect of a specific phosphodiesterase-5 inhibitor, sildenafil, has recently been reported in patients with primary pulmonary hypertension, little information is available regarding the effect of sildenafil on patients with pulmonary veno-occlusive disease. In the present case, remarkable improvement of hemodynamics and of clinical course was produced by adjunctive use of oral sildenafil in association with intravenous high-dose epoprostenol. These findings suggest that sildenafil may be a therapeutic option in the medical treatment of pulmonary veno-occlusive disease.

• Authors: Tadashi Kuroda, Hisao Hirota, Mitsuru Masaki, Shoko Sugiyama, Yuichi Oshima, Kazuo Terai, Akihiko Ito, Keiko Yamauchi-Takihara
• Journal: Heart, lung & circulation (Heart Lung Circ) Vol. 15 Issue 2 Pg. 139-42 (Apr 2006) ISSN: 1443-9506 [Print] Australia
• PMID: 16574537 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antihypertensive Agents
• Phosphodiesterase Inhibitors
• Piperazines
• Purines
• Sulfones
• Vasodilator Agents
• Sildenafil Citrate
• Epoprostenol

Topics

• Adult
• Antihypertensive Agents (pharmacology, therapeutic use)
• Drug Therapy, Combination
• Dyspnea (drug therapy, physiopathology)
• Epoprostenol (pharmacology, therapeutic use)
• Humans
• Lung (pathology)
• Male
• Phosphodiesterase Inhibitors (pharmacology, therapeutic use)
• Piperazines (pharmacology, therapeutic use)
• Pulmonary Veno-Occlusive Disease (diagnosis, drug therapy, physiopathology)
• Purines (pharmacology, therapeutic use)
• Sildenafil Citrate
• Sulfones (pharmacology, therapeutic use)
• Treatment Outcome
• Vasodilator Agents (pharmacology, therapeutic use)