EFFECTS OF TADALAFIL ON CARDIOPULMONARY HAEMODYNAMICS IN PATIENTS OF CHRONIC PULMONARY DISEASES WITH PULMONARY HYPERTENSION: A PILOT STUDY

Abstract

Background and Objectives: Effect of tadalafil on cardiopulmonary haemodynamics in patients of chronic pulmonary diseases residing at an altitude has not been studied adequately. The present study reports the effect of tadalafil on cardiopulmonary haemodynamics in patients of chronic pulmonary diseases with PH residing at an altitude ranging between 1000 meters to 2500 meters above mean sea level.

Methods: Seventy six patients of chronic pulmonary diseases with PH diagnosed by echocardiography were randomized to receive tadalafil 40 mg once a day or to the control group. The effect of tadalafil on cardiopulmonary haemodynamics was assessed after 3 months of tadalafil exposure. The echo Doppler derived indices of cardiopulmonary haemodymics recorded were; TR gradient, pulmonary flow acceleration time, pulmonary vascular resistance, myocardial performance index, RV eccentricity index, tricuspid annular plane systolic excursion and cardiac output. The arterial oxygen saturation was measured by Pulse oxymeter.

Results and Interpretation: Tadalafil significantly improved the indices of RV performance; pulmonary flow velocity time integral (14.54 ± 3.17cm versus 12.25 ± 2.25cm, p <0.0002), tricuspid annular plane systolic excursion (18.53±4.0mm versus 17.11±3.94mm, p<0.002), RVFS 30.6% vs. 24.8% p<0.003. There was no significant change in the TR gradient although PFAT increased significantly with tadalafil; (89.8±11.7 vs. 76.2±8.2 msec. p<0.001). There was a trend of lower PVR with tadalafil buts not statistically significant 3.6±0.9 vs. 3.1±1.0. Tadalafil also improved the arterial oxygen saturation, SPO₂ (90.91±1.76% versus 88.40±1.79%, p<0.0001) significantly.

Conclusions: Tadalafil improved RV function significantly but its effect on PVR was modest.