Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with <scp>PDE</scp>‐5 inhibitors

Zimmermann, G.; Wulffen, Werner von; Huppmann, Patrick; Meis, Tobias; Ihle, Franziska; Geiseler, Jens; Leuchte, Hanno; Tufman, Amanda; Behr, Jüergen; Neurohr, Claus

doi:10.1111/resp.12294

Cited by 44 publications

(29 citation statements)

References 30 publications

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“…Sildenafil has also been found to improve quality of life in these patients [101]. In a further study, sildenafil and tadalafil were used for the treatment of PH in IPF and hypersensitivity pneumonitis (HP) [102]. After a minimum 3 months of treatment, an increase in cardiac index (CI) and decrease in PVR were observed but 6MWT and BNP level did not change significantly.…”

Section: Treatmentmentioning

confidence: 99%

Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

Zangiabadi

Pasquale

Sajkov

2014

BioMed Research International

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Group 3 pulmonary hypertension (PH) is a common complication of chronic lung disease (CLD), including chronic obstructive pulmonary disease (COPD), interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV) range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.

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Section: Treatmentmentioning

confidence: 99%

Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

Zangiabadi

Pasquale

Sajkov

2014

BioMed Research International

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“…The clinical studies performed both in DPLD and in PH-DPLD confirmed that sildenafil did not carry a significant risk of worsening of oxygenation [26,27,39,45].…”

Section: Is the Treatment Efficacy Related To The Class Of Pah-specifmentioning

confidence: 65%

“…Zimmerman et al [45] found significant haemodynamic improvement in 10 ILD patients treated with 5PDEi in the open label observational study.…”

Section: Rationale For Pah-specific Drugs Use In Ph-dpldmentioning

confidence: 94%

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Pulmonary Hypertension in Diffuse Parenchymal Lung Diseases—Is There Any Benefit of PAH-Specific Therapy?

Szturmowicz¹,

Kacprzak²,

Kuś³

2017

Advances in Respiratory Medicine

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Pulmonary hypertension (PH) is diagnosed in 40-50% of the patients with end-stage diffuse parenchymal lung diseases (DPLD), and it is associated with significant worsening of life expectancy. Latest ERS/ESC guidelines recommend best available treatment of DPLD, and long-term oxygen therapy in the patients with PaO 2 less than 60 mm Hg. Pulmonary arterial hypertension (PAH)-targeted drugs are not recommended in PH-DPLD patients, due to the risk of increasing the ventilation-perfusion mismatch, and consequently worsening of hypoxaemia. Nevertheless, PAH-oriented treatment may be beneficial to selected groups of patients. The authors try to find the answer to several important questions: is there any benefit of PAH-specific therapy in PH-DPLD, who should be the candidate for PAH-specific therapy, what class of drugs is most promising, and what outcome measures should be employed?

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“…Right heart catheterization was performed as described previously ( n = 19) . Pulmonary function testing and blood gas analysis were performed according to the European Respiratory Society Guidelines .…”

Section: Methodsmentioning

confidence: 99%

Suspected pulmonary embolism in patients with pulmonary fibrosis: Discordance between ventilation/perfusion SPECT and CT pulmonary angiography

Leuschner

Wenter²,

Milger

et al. 2016

Respirology

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Background and Objective: Pulmonary embolism (PE) is a common differential diagnosis in patients with pulmonary fibrosis presenting with a clinical deterioration. Both ventilation/perfusion (V/Q)-single photon emission computed tomography (SPECT) and computed tomographic pulmonary angiography (CTPA) are routinely used to detect PE. However, the value of V/Q-SPECT and CTPA in this scenario has not been studied so far. We aimed to investigate the concordance of V/Q-SPECT and CTPA in patients with pulmonary fibrosis and suspicion of pulmonary embolism. Methods: A total of 22 consecutive patients with pulmonary fibrosis and clinical deterioration who underwent both V/Q-SPECT and CTPA were included in the study and analyzed for the presence of pulmonary embolism. Results: Nine of 22 patients (41%) had evidence for pulmonary embolism in V/Q-SPECT, and two of these patients had matching evidence for pulmonary embolism in CTPA. In the other seven patients with positive findings in V/Q-SPECT, no evidence of pulmonary embolism was found in CTPA. None of the 13 patients with a negative V/Q-SPECT had evidence for pulmonary embolism in CTPA. Conclusion: In patients with pulmonary fibrosis and suspected pulmonary embolism, pulmonary embolism is detected more frequently by V/Q-SPECT than by CTPA. Thromboembolic disease is identified on CTPA only in a minority of patients with positive findings on V/Q-SPECT. When making treatment decisions, clinicians should be aware of the high rate of discordant findings in V/Q-SPECT and CTPA in this specific patient population.

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Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with PDE‐5 inhibitors

Abstract: Our data suggest that treatment with PDE-5 inhibitors improves pulmonary haemodynamic patients with PH secondary to ILD.

Cited by 44 publications

References 30 publications

Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

Pulmonary Hypertension in Diffuse Parenchymal Lung Diseases—Is There Any Benefit of PAH-Specific Therapy?

Suspected pulmonary embolism in patients with pulmonary fibrosis: Discordance between ventilation/perfusion SPECT and CT pulmonary angiography

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