ArticleClinical research in cardiology : official journal of the German Cardiac Society2014
Predictors of sildenafil effects on exercise capacity in adolescents and adults with Fontan circulation.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Pharmacology Management in Improving Exercise Capacity of Patients with Fontan Circulation: A Systematic Review and Meta-analysis.Current cardiology reviews · 2022Pooled it
- Pulmonary Vasodilator Therapy in Patients With Fontan Circulation: A Meta-Analysis.Korean circulation journal · 2025Article
- Randomized, Placebo-Controlled Trial of Peri-Operative Treprostinil in Pediatric Patients Undergoing the Fontan Operation.Pulmonary circulation · 2025Article
- Cardiac Drugs in ACHD Cardiovascular Medicine.Journal of cardiovascular development and disease · 2023Review
- Management of circulatory failure after Fontan surgery.Frontiers in pediatrics · 2022Review
- Treatment of pulmonary arterial hypertension in children.Cardiovascular diagnosis and therapy · 2021Review
- Multisite measurement of regional oxygen saturation in Fontan patients with and without protein-losing enteropathy at rest and during exercise.Pediatric research · 2019Article
- Long-Term Serial Follow-Up of Pulmonary Artery Size and Wall Shear Stress in Fontan Patients.Pediatric cardiology · 2016Article
- Effect of Inhaled Nitric Oxide on Blood Flow Dynamics in Patients After the Fontan Procedure Using Cardiovascular Magnetic Resonance Flow Measurements.Pediatric cardiology · 2016Article
- Estimating equations for cardiopulmonary exercise testing variables in Fontan patients: derivation and validation using a multicenter cross-sectional database.Pediatric cardiology · 2015Article
- The efficacy and safety of pulmonary vasodilators in patients with Fontan circulation: a meta-analysis of randomized controlled trials.Pulmonary circulationArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveA single dose of sildenafil improves exercise capacity in Fontan patients. However, a recent study failed to show a long-term effect of sildenafil. This study evaluated whether there are factors that might predict sildenafil effects.
methodsWe studied 36 patients (16-42 years, 14 female) with univentricular heart after various modifications of the Fontan surgery (13 APC, 16 AVC, 7 TCPC). They performed two cardiopulmonary exercise tests, with at least 120 min rest and a single dose of 50 mg sildenafil in between.
resultsAfter sildenafil administration, patients improved their peak oxygen uptake from 64.5 to 67.3 % predicted (p = 0.0003) without change in ventilatory efficiency ([Formula: see text] slope), oxygen saturation (SpO2) at rest or at peak exercise, respiratory exchange ratio. In addition, resting systolic blood pressure was slightly reduced after sildenafil administration. There was a moderate negative correlation of this improvement to baseline peak oxygen uptake (r = -0.395; p = 0.017). The change in peak oxygen uptake could not be correlated to time of surgery, type of surgery, NT-pro-BNP, or to other clinical data. Nevertheless, all four patients with NT-pro-BNP levels higher than 1,000 pg/ml had the most prominent improvements in exercise capacity.
conclusionsFontan patients have an improved exercise capacity after a single dose of sildenafil. Patients with worse baseline peak oxygen uptake profit more.
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