Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report

<p>Abstract</p> <p>Background</p> <p>Portopulmonary hypertension (PPHTN) is a severe complication in liver cirrhosis. PDE5 inhibitors lower pulmonary arterial pressure (PAP) in PPHTN. However, their effect on portal hypertension has not yet been investigated.</p>...

Full description

Bibliographic Details
Main Authors: Bremer Hinrich C, Kreisel Wolfgang, Roecker Kai, Dreher Michael, Koenig Daniel, Kurz-Schmieg Anna, Blum Hubert E, Roessle Martin, Deibert Peter
Format: Article
Language:English
Published: BMC 2007-07-01
Series:Journal of Medical Case Reports
Online Access:http://www.jmedicalcasereports.com/content/1/1/46
id doaj-b751384391634cf8b47a3a63e5af3daf
record_format Article
spelling doaj-b751384391634cf8b47a3a63e5af3daf2020-11-24T23:08:01ZengBMCJournal of Medical Case Reports1752-19472007-07-01114610.1186/1752-1947-1-46Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case reportBremer Hinrich CKreisel WolfgangRoecker KaiDreher MichaelKoenig DanielKurz-Schmieg AnnaBlum Hubert ERoessle MartinDeibert Peter<p>Abstract</p> <p>Background</p> <p>Portopulmonary hypertension (PPHTN) is a severe complication in liver cirrhosis. PDE5 inhibitors lower pulmonary arterial pressure (PAP) in PPHTN. However, their effect on portal hypertension has not yet been investigated.</p> <p>Case presentation</p> <p>A 55 year old male patient presented with PPHTN and alcoholic liver cirrhosis. 10 mg of Tadalafil, a PDE5 inhibitor with a long half-life, was administered orally under continuous monitoring of pulmonary and portal hemodynamics. For maintenance therapy the patient received Sildenafil 20 mg bid.</p> <p>Tadalafil lowered mean PAP from 45 to 39 mmHg within 60 minutes. Cardiac output (CO) increased from 6.8 to 7.9 l/min. Central venous pressure (CVP) remained stable at 3 mmHg. Systolic and diastolic blood pressure was lowered from 167/89 to 159/86 mmHg. Pulse rate increased from 75 to 87 per min. Wedged hepatic vein pressure (WHVP) decreased from 21 to 18 mm Hg, hepatovenous pressure gradient (HVPG) decreased from 10 to 7 mmHg. Hemodynamic monitoring after 6 months of Sildenafil therapy revealed a sustained lowering of mean PAP. HVPG remained constant at 10 mmHg. Cardiac and pulmonary performance had further improved.</p> <p>Conclusion</p> <p>This case report shows for the first time, that phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension.</p> http://www.jmedicalcasereports.com/content/1/1/46
collection DOAJ
language English
format Article
sources DOAJ
author Bremer Hinrich C
Kreisel Wolfgang
Roecker Kai
Dreher Michael
Koenig Daniel
Kurz-Schmieg Anna
Blum Hubert E
Roessle Martin
Deibert Peter
spellingShingle Bremer Hinrich C
Kreisel Wolfgang
Roecker Kai
Dreher Michael
Koenig Daniel
Kurz-Schmieg Anna
Blum Hubert E
Roessle Martin
Deibert Peter
Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
Journal of Medical Case Reports
author_facet Bremer Hinrich C
Kreisel Wolfgang
Roecker Kai
Dreher Michael
Koenig Daniel
Kurz-Schmieg Anna
Blum Hubert E
Roessle Martin
Deibert Peter
author_sort Bremer Hinrich C
title Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
title_short Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
title_full Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
title_fullStr Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
title_full_unstemmed Phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
title_sort phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension: a case report
publisher BMC
series Journal of Medical Case Reports
issn 1752-1947
publishDate 2007-07-01
description <p>Abstract</p> <p>Background</p> <p>Portopulmonary hypertension (PPHTN) is a severe complication in liver cirrhosis. PDE5 inhibitors lower pulmonary arterial pressure (PAP) in PPHTN. However, their effect on portal hypertension has not yet been investigated.</p> <p>Case presentation</p> <p>A 55 year old male patient presented with PPHTN and alcoholic liver cirrhosis. 10 mg of Tadalafil, a PDE5 inhibitor with a long half-life, was administered orally under continuous monitoring of pulmonary and portal hemodynamics. For maintenance therapy the patient received Sildenafil 20 mg bid.</p> <p>Tadalafil lowered mean PAP from 45 to 39 mmHg within 60 minutes. Cardiac output (CO) increased from 6.8 to 7.9 l/min. Central venous pressure (CVP) remained stable at 3 mmHg. Systolic and diastolic blood pressure was lowered from 167/89 to 159/86 mmHg. Pulse rate increased from 75 to 87 per min. Wedged hepatic vein pressure (WHVP) decreased from 21 to 18 mm Hg, hepatovenous pressure gradient (HVPG) decreased from 10 to 7 mmHg. Hemodynamic monitoring after 6 months of Sildenafil therapy revealed a sustained lowering of mean PAP. HVPG remained constant at 10 mmHg. Cardiac and pulmonary performance had further improved.</p> <p>Conclusion</p> <p>This case report shows for the first time, that phosphodiesterase 5 inhibitors lower both portal and pulmonary pressure in portopulmonary hypertension.</p>
url http://www.jmedicalcasereports.com/content/1/1/46
work_keys_str_mv AT bremerhinrichc phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT kreiselwolfgang phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT roeckerkai phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT drehermichael phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT koenigdaniel phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT kurzschmieganna phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT blumhuberte phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT roesslemartin phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
AT deibertpeter phosphodiesterase5inhibitorslowerbothportalandpulmonarypressureinportopulmonaryhypertensionacasereport
_version_ 1725615898311524352