Abstract

SARJANOVICH, Rodolfo Juan  and  LEMA, Luis. Sildenafil for everyone?. Insuf. card. [online]. 2010, vol.5, n.1, pp.32-41. ISSN 1852-3862.

Since the first description by Victor Eisenmenger and Werner Forssmann the late nineteenth and early twentieth centuries, much progress has been made in understanding the pathophysiological mechanisms that cause the disease and this allowed a more rational therapeutic approach. However, all applied pharmacology to improve the quality of life and survival of these patients has only been tested in patients in group I with the exclusion of other patients. However, epidemiological data tell us that the vast majority of patients with pulmonary arterial hypertension (PAH) belong to groups II, III and IV, where these drugs have not been tested. Sildenafil is a mainstay treatment for their performance and for being easily accessible for patients and physicians. In patients with chronic obstructive pulmonary disease, the presence of PAH worsens prognosis, but severe cases are a very low and usually due to another cause. Vasodilation of pulmonary arterioles produce an imbalance in the ventilation / perfusion worsens hypoxia, however minor in these patients treated with sildenafil have demonstrated safety and improvement in the test of the 6-minute walk. In heart failure, sildenafil may exacerbate the pulmonary edema, but many studies with small numbers of patients have improved functional capacity, peak oxygen consumption and gas exchange parameters. In PAH due to chronic thromboembolism is recommended thrombectomy of the pulmonary arteries. But in inoperable cases, sildenafil has been helpful.

Keywords : Pulmonary hypertension; Sildenafil; Chronic obstructive pulmonary disease; Heart failure; Chronic thromboembolism.

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