| Texto completo | |
| Autor(es): |
Clave, Mariana M.
[1]
;
Maeda, Nair Y.
[2]
;
Thomaz, Ana M.
[1]
;
Bydlowski, Sergio P.
[3]
;
Lopes, Antonio A.
[1]
Número total de Autores: 5
|
| Afiliação do(s) autor(es): | [1] Univ Sao Paulo, Sch Med, Heart Inst, Sao Paulo - Brazil
[2] Pro Sangue Fdn, Sao Paulo - Brazil
[3] Univ Sao Paulo, Sch Med, LIM 31, Sao Paulo - Brazil
Número total de Afiliações: 3
|
| Tipo de documento: | Artigo Científico |
| Fonte: | CONGENITAL HEART DISEASE; v. 14, n. 2, p. 246-255, MAR-APR 2019. |
| Citações Web of Science: | 2 |
| Resumo | |
Background Ideally, vasodilator therapies for pulmonary arterial hypertension (PAH) should have a favorable impact on markers of vascular dysfunction, in addition to their known effects on hemodynamics, cardiac function, and patient's physical capacity. Methods We analyzed circulating (plasma) markers of endothelial and platelet activation/dysfunction (enzyme-linked immunoassays) in the specific setting of advanced PAH associated with congenital heart disease, during the course of sildenafil and tadalafil therapies. Thirty-one patients were enrolled (age 10-54 years), most of them with chronic hypoxemia and elevated hematocrit. Drugs were administered orally for 6 months (sildenafil {[}n = 16], 20 mg t.i.d.; tadalafil {[}n = 15], single daily dose of 40 mg). Measurements were performed at baseline, and 90 and 180 days. Results Compared to controls, patients had elevated baseline beta-thromboglobulin (beta-TG, P = .002), P-selectin (P = .027), tissue-type plasminogen activator (t-PA, P = .009), and von Willebrand factor antigen (VWF:Ag, P = .010). Thrombomodulin was importantly reduced (TM, P < .001), while soluble CD40 Ligand was not changed (P = .320). Tadalafil administration was associated with improvement of beta-TG (P = .004), t-PA (P = .003) and TM (P = .046) levels, while P-selectin was improved by sildenafil treatment only (P = .034). VWF:Ag improved transiently in the sildenafil group (P = .019). Both therapies were associated with improvement of the physical capacity (functional class and distance walked during the 6-minute test, P < .05), hematocrit and hemoglobin level (P < .05), and health-related quality of life (physical and mental components, P < .05). Conclusion In PAH associated with congenital heart disease, phosphodiesterase 5 inhibitors seem to have beneficial actions at microcirculatory level, beyond the proposed effects as vasodilators. (AU) | |
| Processo FAPESP: | 12/10739-0 - Estudo dos efeitos do uso crônico da tadalafila, independentemente e comparativamente à Sildenafila, em portadores de hipertensão arterial pulmonar associada a cardiopatias congênitas em sua forma mais avançada (Síndrome de Eisenmenger) |
| Beneficiário: | Antonio Augusto Barbosa Lopes |
| Modalidade de apoio: | Auxílio à Pesquisa - Regular |