PDE 5 inhibition with udenafil improves left ventricular systolic/diastolic functions and exercise capacity in patients with chronic heart failure with reduced ejection fraction; A 12-week, randomized, double-blind, placebo-controlled trial

Therapeutic benefits of Phosphodiesterase-5 inhibition in chronic heart failure: A meta-analysis

“…1, Tables III and IV). Among them, 13 were RCTs [7][8][9][10][11][12][13][14][15][16][18][19][20] and 1 was a subgroup analysis [17]. Patients affected by HFREF included in our meta-analysis were 555.…”

“…In particular, among the six RCTs that had investigated the peak VO 2 in HFREF patients [9,10,12,13,16,18] this parameter was improved by the use of PDE5i (MD: 3.76; 95% CI: 3.27-4.25; p < 0.0001; Fig. 4).…”

“…As regards the assessment of LVEF in patients with HFREF, based on the results of four studies [10,13,16,18], the use of PDE5i was associated with a significant increase in LVEF compared to placebo (MD: 4.30%; 95% CI: 2.18%-6.42%; p < 0.0001; Fig. 6).…”

“…Seven RCTs of HFREF [7,12,13,15,16,18,20] reported clinical outcomes, with 5 hospitalization events occurring in the PDE5i arm and 17 occurring in the control arm. These results indicate a significant benefit conferred by PDE5i against hospitalization (OR = 0.28; 95% CI: 0.10-0.74; p = 0.03; Fig.…”

“…This has to be emphasized because based on seven studies [7,12,13,15,16,18,20], it testifies the existence of an important protective role of PDE5i against the risk of death and hospitalizations in HFREF patients. Among the studies incorporated in the meta-analysis, sildenafil was used in six studies and udenafil in one, with a total of 460 patients investigated E/e′ ratio in HFREF and HFpEF patients …”