uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Acute vasodilator response to vardenafil and clinical outcome in patients with pulmonary hypertension
Umea Univ, Div Clin Pharmacol, Dept Pharmacol & Clin Neurosci, Umea, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry. Natl Vet Inst SVA, Dept Chem, Uppsala, Sweden..
Show others and affiliations
2015 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 71, no 10, 1165-1173 p.Article in journal (Refereed) Published
Abstract [en]

Purpose Acute vasodilator testing is recommended in patients with pulmonary arterial hypertension to identify individuals who may benefit from long-term treatment with oral calcium channel blockers. The aim of this study was to investigate the use of vardenafil in acute vasoreactivity testing compared to adenosine. Methods A total of 20 patients eligible for right heart catheterisation were enrolled. Acute vasoreactivity testing was carried out with intravenous (iv) adenosine (n = 18) followed by oral vardenafil (n = 20). Haemodynamic responses were recorded at baseline and after 60 min (vardenafil). Responders were defined according to consensus guideline criteria. Results Both vardenafil and adenosine significantly decreased mean pulmonary arterial pressure (mPAP, p < 0.001 and p = 0.026, respectively) and pulmonary vascular resistance (p < 0.001 and p > 0.001, respectively), and significantly increased cardiac output (p = 0.001 and p = 0.005, respectively). Vardenafil reduced mPAP more than adenosine (p = 0.044), while adenosine resulted in higher responses of cardiac index (p = 0.009) and pulmonary arterial oxygen saturation (p = 0.042). Acute adverse reactions were common with adenosine, while no side effects were observed after a single oral dose vardenafil. Vardenafil identified five responders (out of 20), while adenosine identified three responders (out of 18). During a 7-year follow-up, vardenafil responders had significantly lower NT-proBNP levels compared to non-responders. Conclusions Vardenafil may be safely used for acute vasoreactivity testing in patients with PH. A single oral dose of vardenafil is better tolerated than iv adenosine and may identify additional responders who could benefit from long-term vasodilator treatment.

Place, publisher, year, edition, pages
2015. Vol. 71, no 10, 1165-1173 p.
Keyword [en]
Adenosine, Vardenafil, Acute vasodilator test, Haemodynamics, Pulmonary hypertension, Right heart catheterisation
National Category
Pharmacology and Toxicology
URN: urn:nbn:se:uu:diva-264031DOI: 10.1007/s00228-015-1914-zISI: 000360996300002PubMedID: 26242227OAI: oai:DiVA.org:uu-264031DiVA: diva2:859417
Available from: 2015-10-07 Created: 2015-10-05 Last updated: 2015-10-07Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Hedeland, MikaelWernroth, LisaBondesson, UlfWikström, Gerhard
By organisation
Department of Medical SciencesAnalytical Pharmaceutical ChemistryUCR-Uppsala Clinical Research CenterCardiology
In the same journal
European Journal of Clinical Pharmacology
Pharmacology and Toxicology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 155 hits
ReferencesLink to record
Permanent link

Direct link