Source: Annual Congress 2007 - Pulmonary vascular involvement in smoking and respiratory diseases
Disease area: Pulmonary vascular diseases

Abstract

Rationale Pulmonary hypertension (PH) is a common complication in COPD. PH is generally mild to moderate in COPD and becomes more manifest during exercise. Sildenafil has been shown to reduce pulmonary artery pressure and improve exercise capacity in various forms of pulmonary hypertension.
Aim To investigate long-term effects of sildenafil on exercise performance and cardiopulmonary exercise test characteristics, such as oxygen pulse and ventilatory efficiency in COPD patients.
Methods: 14 Stable COPD patients (GOLD III-IV) were included (9 male, 5 female, mean age 65± 9 years, mPpa 20±8 mmHg; PVR 270±170 dynes·s^-1·cm^-5). Patients performed a 6-min walk test (6MWD) and a maximal cardiopulmonary exercise test (CPET) with blood gas analysis. All measurements were repeated after 12 weeks of oral sildenafil therapy, 20 mg three times daily.
Results: After 3 months of sildenafil there was no improvement in six minutes walk distance. No change was found in maximal exercise capacity and CPET characteristics remained unchanged (Table).
Conclusion: Sildenafil did not improve exercise capacity, and no changes were found in CPET characteristics in COPD patients with mild or absent PH at rest.

CPET characteristics

	Baseline	After 3 months of sildenafil
6-mwd, m	389 ± 134	394 ± 120
Peak VO2, ml/kg/min	12.1 ± 3.6	12.4 ± 3.8
Δ VO2 /Δ workload	8.0 ± 1.6	8.8 ± 1.9
Ve/VCO2 slope	46 ± 27	40 ± 17
O2-pulse, ml/beat	7.4 ± 1.6	7.3 ± 1.3
PaCO2 kPa exercise	5.4 ± 1.1	5.4 ± 1.1
PaO2 kPa exercise	8.3 ± 2	8.4 ± 2

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Citations should be made in the following way:
H. Rietema, S. Holverda, H. J. Bogaard, A. Boonstra, P. Postmus, A. Vonk-Noordegraaf (Amsterdam, Netherlands). Long-term effect of sildenafil on exercise capacity in COPD patients. Eur Respir J 2007; 30: Suppl. 51, 3581

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