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Pulmonary hypertension (PH) and associated RV systolic dysfunction are common in patients with LV systolic dysfunction (LVSD) and are associated with reduced exercise capacity and increased risk for death. Although one-time use of sildenafil, a type-5 phosphodiesterase (PDE5) inhibitor, improves pulmonary vascular resistance (PVR) and exercise tolerance in patients with PH due to LVSD, the effects of longer-term use are unknown. In a trial partially funded by the manufacturer, investigators randomized 34 patients with LVSD, PH (mean pulmonary pressure >25 mm Hg), and NYHA class-II-to-IV symptoms despite standard medical therapy to receive either sildenafil (25 mg titrated to ≤75 mg) or placebo three times daily.
Participants had a mean LV ej…