Acute hemodynamic response in relation to plasma vardenafil levels in patients with pulmonary hypertension
British Journal of Clinical Pharmacology, 05/10/2012Henrohn D et al.
Vardenafil causes rapid changes in cardiopulmonary hemodynamics, and there is a correlation between plasma vardenafil drug concentration and the acute changes in mPAP as well as PVR in patients with PH.
Sixteen patients with PH (aged 29–85 years), received one single oral dose of vardenafil (5, 10, or 20 mg).
The hemodynamic effect was assessed over a 60–min period.
Vardenafil plasma concentrations were measured after 15, 30, 45, and 60 min using liquid chromatography–tandem mass spectrometry.
At 60 min a reduction in mPAP with a median percent decrease of –20.3% (range –48.3 to 3.0; p < 0.001) and an increase in cardiac output and the cardiac index with a median percent change of 10.6% (range –25.0 to 88.1; p = 0.015) and 12.1% (range –24.0 to 94.4; p = 0.01) respectively was observed.
The pulmonary vascular resistance (PVR) was reduced with a median percent decrease of –28.9% (range –61.5 to –5.9; p < 0.001), and pulmonary selectivity was reflected by a median percent reduction of –16.9% (range –49.0 to 16.5; p = 0.002; n = 14) in the PVR/systemic vascular resistance ratio.
There was a correlation between the plasma concentrations of vardenafil and change in mPAP (r = –0.579, p = 0.019), and between vardenafil concentrations and change in PVR (r = –0.662, p = 0.005).
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