{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:43:47Z","timestamp":1783975427031,"version":"3.55.0"},"reference-count":40,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["32003B_197706"],"award-info":[{"award-number":["32003B_197706"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2025,3,7]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background and aims<\/jats:title>\n                  <jats:p>Patients with precapillary pulmonary hypertension (PH) due to pulmonary vascular disease (PVD) have reduced exercise capacity, limiting daily activity and quality of life. Phospodiesterase-5 inhibitors, including sildenafil, are used to treat PVD. This study examined effects of sildenafil on pulmonary haemodynamics during exercise in PVD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>PVD patients diagnosed with pulmonary arterial hypertension (PAH) or chronic thromboembolic PH (CTEPH) underwent right heart catheterisation assessed at rest and during mild exercise. Main outcomes were mean pulmonary artery pressure (mPAP), cardiac output (CO) and the mPAP\/CO slope before and \u223c60\u2005min after additive sildenafil (50\u2005mg oral).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>22 PVD patients (14 PAH, 8 CTEPH, 9 women and 15 pretreated (9 combination therapy)) with a mean\u00b1<jats:sc>sd<\/jats:sc> age of 54\u00b114\u2005years, mPAP 39\u00b110\u2005mmHg, CO 4.7\u00b11.5\u2005L\u00b7min<jats:sup>\u22121<\/jats:sup> and pulmonary vascular resistance 6.9\u00b13.8\u2005WU were included. After sildenafil, mPAP and CO at rest were unchanged, but at end-exercise, mPAP and the mPAP\/CO slope significantly decreased (mPAP 61\u00b116 <jats:italic>versus<\/jats:italic> 54\u00b116\u2005mmHg; mean difference \u22127, 95% confidence interval (CI) \u221211 to \u22124; p&lt;0.001 and mPAP\/CO slope 9.8\u00b14.9 <jats:italic>versus<\/jats:italic> 6.6\u00b13.3; \u22123, 95% CI \u22124.9 to \u22121.2; p=0.002). The mean systemic arterial pressure was significantly lower after additive sildenafil at rest (\u22129\u2005mmHg, \u221213 to \u22125; p&lt;0.001) and at end-exercise (\u22129\u2005mmHg, \u221213 to \u22125; p&lt;0.001). One patient experienced dizziness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with PVD, showed favourable acute pulmonary haemodynamic changes during exercise after additive sildenafil, indicated by a reduced mPAP and mPAP\/CO slope. Sildenafil was generally well tolerated despite lower blood pressure. Further investigation is needed to determine if sildenafil as a \u201cpill-in-the-pocket\u201d strategy improves exercise capacity in PVD patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1183\/23120541.01392-2024","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T08:52:27Z","timestamp":1743670347000},"page":"01392-2024","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute effects of 50\u2005mg additive oral sildenafil on invasive exercise haemodynamics in pulmonary vascular disease"],"prefix":"10.1183","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3635-0515","authenticated-orcid":false,"given":"Simon R.","family":"Schneider","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-1758","authenticated-orcid":false,"given":"Mona","family":"Lichtblau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4059-5937","authenticated-orcid":false,"given":"Julian","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meret","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4949-8548","authenticated-orcid":false,"given":"Laura","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-981X","authenticated-orcid":false,"given":"Esther I.","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8518-5029","authenticated-orcid":false,"given":"Michael","family":"Furian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-6277","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Saxer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-5022","authenticated-orcid":false,"given":"Silvia","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"2025092202452030000_11.5.01392-2024.1","doi-asserted-by":"crossref","first-page":"e026400","DOI":"10.1161\/JAHA.122.026400","article-title":"EmPHasis-10 health-related quality of life and exercise capacity in chronic thromboembolic pulmonary hypertension after balloon angioplasty","volume":"11","author":"Sakamoto","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2025092202452030000_11.5.01392-2024.2","doi-asserted-by":"publisher","DOI":"10.1159\/000342351"},{"key":"2025092202452030000_11.5.01392-2024.3","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00130405"},{"key":"2025092202452030000_11.5.01392-2024.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"2025092202452030000_11.5.01392-2024.5","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01889-2018"},{"key":"2025092202452030000_11.5.01392-2024.6","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1093\/eurheartj\/ehaa696","article-title":"Standardized exercise training is feasible, safe, and effective in pulmonary arterial and chronic thromboembolic pulmonary hypertension: results from a large European multicentre randomized controlled trial","volume":"42","author":"Grunig","year":"2021","journal-title":"Eur Heart J"},{"key":"2025092202452030000_11.5.01392-2024.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.02.634"},{"key":"2025092202452030000_11.5.01392-2024.8","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00990-2016"},{"key":"2025092202452030000_11.5.01392-2024.9","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03181-2021"},{"key":"2025092202452030000_11.5.01392-2024.10","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0284-2020"},{"key":"2025092202452030000_11.5.01392-2024.11","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201211-2090CI"},{"key":"2025092202452030000_11.5.01392-2024.12","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2012.tb00405.x"},{"key":"2025092202452030000_11.5.01392-2024.13","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1159\/000453620","article-title":"Mechanisms of improved exercise performance under hyperoxia","volume":"93","author":"Ulrich","year":"2017","journal-title":"Respiration"},{"key":"2025092202452030000_11.5.01392-2024.14","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00563-2022"},{"key":"2025092202452030000_11.5.01392-2024.15","unstructured":"Smith BP , Babos M . 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