Heart failure & cardiomyopathies
Phosphodiesterase-5 Inhibitors for Left Ventricular Assist Device Implantation Complicated by Right Ventricular Failure
Authors' conclusion
In LVAD patients with a history of early post-operative RV failure, discontinuation of long-term PDE5I therapy was not associated with deterioration of RV function, exercise capacity, and quality of life.
Study context
- Population
- Clinically stable left ventricular assist device (LVAD) recipients on long-term oral PDE5I therapy after early post-operative right ventricular (RV) failure
- Participants
- 31 recipients
- Exposure
- 4 weeks after PDE5I withdrawal vs baseline on PDE5I
- Outcome
- RV function and cardiopulmonary exercise capacity
- Follow-up
- 4 weeks after PDE5I withdrawal
Methodological detailsPDE5I withdrawal, before–after comparison, Mean age 53 years; 90% male
- PDE5I withdrawal
- Before–after comparison
- Mean age 53 years; 90% male
Main finding
As reported in the abstract
Peak tricuspid regurgitation velocity increased, baseline vs 4 weeks
2.1 vs. 2.4 m/s
P = 0.01
Peak oxygen consumption, baseline vs 4 weeks: no significant change
11.4 vs. 11.8 mL/min/kg
P = 0.52
Minute ventilation/carbon dioxide production slope, baseline vs 4 weeks: no significant change
33 vs. 35
P = 0.56
Observational data: associations, not effects.
Further findings
NT-proBNP, baseline vs 4 weeks
- No significant change
- 1455 vs. 1399 pg/mL, P = 0.55
Quality of life (Kansas City Cardiomyopathy Questionnaire score), baseline vs 4 weeks
- No significant change
- 78.3% vs. 77.5%, P = 0.62
Device flow and power readings · 4 weeks
- No significant changes
6-min walking distance, baseline vs 4 weeks
- Increase
- 346 vs. 364 m, P = 0.03
Safety
Hospitalisation
- Hospitalised for non-cardiac reasons (subtherapeutic INR, driveline infection)
- 2
- Hospitalised for cardiac decompensation
- 0
Original publication
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