Efficacy of Sildenafil in Secondary Pulmonary Arterial Hypertension

To study the efficacy of sildenafil (Phosphodiesterase 5 inhibitor) on the basis of improvement in six minute walk test (6-MWT) and reduction in Pulmonary Arterial Systolic Pressure (PASP) as measured by 2-D Echocardiography in patient with Secondary PAH.

After initial clinical evaluation, including Doppler Echocardiography and 6-MWT 30 patients with Secondary PAH were commenced on sildenafil 20 mg t.d.s. for a period of 12 weeks and 2D-Echocardiography and 6-MWT were repeated after 12 weeks. Paired t-test was applied to find the statistical significant difference at baseline and 12 weeks after therapy in six minute walk test and PASP at 5% level of significance.

In our study of 30 patients there was a significant increase in 6-MWT distance from baseline (326.33 + 50.27 meters) to 12 weeks after therapy (412.67 + 56.01 meters) with a mean improvement of 86.33 + 31.78 meters (p<0.05), furthermore there was a significant reduction in mean pulmonary arterial pressure from 48.73 + 5.06 mm Hg to 40.53 + 5.49 mm Hg with a mean reduction of 8.20 + 4.59 mm Hg (p<0.05) after therapy. There was no serious side effects with sildenafil.

Our study suggests that sildenafil can be used as a valuable drug in treatment of Secondary Pulmonary Arterial Hypertension.