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SM ISO690:2012 PALII, Ina. Eficacitatea inhibitorului fosfodiesterazei tip 5 – sildenafil în hipertensiunea pulmonară arterială secundară şunturilor
congenitale cu insuficienţă cardiacă. In: Curierul Medical, 2011, nr. 6(324), pp. 54-63. ISSN 1875-0666. |
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Curierul Medical | ||||||
Numărul 6(324) / 2011 / ISSN 1875-0666 | ||||||
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Pag. 54-63 | ||||||
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Pulmonary arterial hypertension (PAH) resulting from congenital cardiac disease remains one of the most difficult childhood illnesses to treat. Sildenafil, a selective inhibitor of phosphodiesterase type 5, is an inexpensive effective and promising pulmonary vasodilator with few minor adverse side-effects. The research evaluated the efficacy of Sildenafil in long-term treatment programs. This double-blind, placebo-controlled study included 77 children who suffered from advanced, residual PAH and secondary to systemic-to-pulmonary shunts (simple, mixed and complex), some who had undergone radical or palliative surgical procedures, and others whose cases were inoperable. It noted clinical and paraclinical signs of PAH and heart failure (HF), and was supplemented by a questionnaire collecting evidence of adverse reactions. The study showed that sildenafil is an effective medicine in treating PAH secondary to congenital systemic-to-pulmonary shunts and HF; improving FC (p < 0,001). The study also showed that Sildenafil increases tolerance of effort (p < 0,01) and systemic O2 saturation (p < 0,05), diminishes PAPm (p < 0,001), PVRI (p < 0,001), proinflammatory cytokines (p < 0,01), endothelin 1 and improves performance on the oxidative stress index. This medicine is well tolerated by infants who experienced insignificant negative reactions, and is effective in preventing severe complications, producing a favorable impact on the quality of life.
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Cuvinte-cheie sildenafil, pulmonary hypertension, heart failure, congenital shunt |
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