Backgrounds: Myocardial phosphodiesterase 5 (PDE5) inhibitors are documented for use in various
disease states. The efficacy of PDE5 inhibitors is less determined in heart failure patients
without pulmonary hypertension. The aim of the present study was to evaluate the efficacy of
PDE5 inhibitors in heart failure patients without pulmonary hypertension.
Method: Seventy-six cases with heart failure were participated in this study. The selection criteria were
systolic heart failure according to the New York Heart Association (NYHA) functional
classifications I and IV, echocardiographically determined left ventricular ejection fraction less
than 50%, and stability for at least 3 months. The participants were randomly divided into case
and control groups. Both case and control groups received 50 mg of sildenafil and a placebo for
3 months, respectively. Transthoracic echocardiography (TTE) was performed using the
Vingmed 800 CSF. All the ejection fraction measurements were done using the Simpson
method. Before the initiation of the trial and then 3 months afterward, TTE was obtained from
the participants. Changes in the functional class and the left ventricular ejection fraction before
and after the trial were assessed and the data were analyzed using SPSS, version 16.
Results: In the case group, the ejection fraction after the trial with an average of 41.53 ± 7.53 was
considerably more significant than that before the trial with an average of 37.92 ± 6.92
(P < 0.001). The findings also showed that sildenafil inhibited PDE5 and the development of
the NYHA IV when given for 90 days. As a result, sildenafil significantly improved the left
ventricular ejection fraction.
Conclusions: PDE5 inhibitors are effective in the treatment of heart failure patients without pulmonary
hypertension.