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Erectile dysfunction drug may benefit cardiac function in young patients with heart defects
Date:5/8/2012

to the lungs, bypassing the heart. However, blood vessels in the lungs develop resistance to this blood, often reducing a patient's ability to tolerate exercise.

Sildenafil, which reduces blood vessel resistance to the flow of blood, is already used to treat pulmonary hypertension (high blood press in lung vessels), as well as erectile dysfunction. Because sildenafil has also shown promise as a treatment for adults with heart failure, the Children's Hospital researchers are exploring whether it may benefit younger patients with certain types of congenital heart disease.

The current study is part of a broader phase 2 clinical trial at The Children's Hospital of Philadelphia, the Sildenafil After the Fontan Operation (SAFO) trial. A previous study from the same research team, published in March 2011, found improvements in exercise performance, as measured by ventilator efficiency, in children and young adults with single-ventricle disease who took sildenafil compared to those who took placebo.

The current study was the first to show that sildenafil improved echocardiographic measures of ventricular performance in children and young adults with single-ventricle physiology. The biological mechanisms that affect ventricular performance are not fully understood, said Goldberg, but he noted that studies in other patients with heart disease suggest that inhibiting the abnormally high levels of the enzyme phosphodiesterase E5 (PDE5) may produce the physiological benefits seen in the single-ventricle patients.

Goldberg cautioned that further research should be pursued to determine if the observed improvements in ventricular performance persist beyond the short term and if they provide clear quality-of-life benefits. "If sildenafil is safe over the medium and long-term, and if it produces durable functional improvements, patients with single-ventricle heart disease could have their first effective long-term treatment," he added.


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Contact: Joey McCool Ryan
McCool@email.chop.edu
267-426-6070
Children's Hospital of Philadelphia
Source:Eurekalert

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