sildenafil and left ventricular (LV) contractility

 Q: Sildenafil (select one) 

A) increases the left ventricular (LV) contractility 

B) reduces the left ventricular (LV) contractility

Answer: B

Sildenafil is a selective type 5 phosphodiesterase (PDE-5) inhibitor. Although its clinical efficacy has been established in Erectile Dysfunction and pulmonary hypertension, so far it has not shown any major benefit in congestive heart failure (CHF). It has three main effects in hemodynamic. 

• It decreases the pulmonary vascular resistance 
• It lowers the systemic arterial load 
• It reduces the left ventricular (LV) contractility

It may improve the peak VO2 in CHF patients with reduced LVEF but no benefit in patients with preserved ejection fraction.

#hemodynamic

#cardiology

#pulmonary

#pharmacology

References:

1. Borlaug BA, Lewis GD, McNulty SE, et al. Effects of sildenafil on ventricular and vascular function in heart failure with preserved ejection fraction. Circ Heart Fail 2015; 8:533. 

2. Zhuang XD, Long M, Li F, et al. PDE5 inhibitor sildenafil in the treatment of heart failure: a meta-analysis of randomized controlled trials. Int J Cardiol 2014; 172:581.