Trial reportEuropean heart journal2018
Sildenafil for improving outcomes in patients with corrected valvular heart disease and persistent pulmonary hypertension: a multicenter, double-blind, randomized clinical trial.
Trial report in European heart journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00862043 (Sildenafil for Improving Outcomes After Valvular Correction), which is not on this map. Cited by 106 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sildenafil for Improving Outcomes After Valvular Correction
Who cites it
106 citing papers in PubMed, 5 syntheses or guidelines pooled it, 223 citations in OpenAlex.
- Brazilian guidelines for the pharmacological treatment of pulmonary hypertension. Official document of the Brazilian Thoracic Society based on the Grading of Recommendations Assessment, Development, and Evaluation methodology.Respiratory research & clinical practice · 2026Guideline
- [Phosphodiesterase 5 inhibitors for the treatment of heart failure: a systematic review and meta-analysis].Archivos de cardiologia de Mexico · 2024Pooled it
- Bias and Loss to Follow-Up in Cardiovascular Randomized Trials: A Systematic Review.Journal of the American Heart Association · 2020Pooled it
- Phosphodiesterase 5 inhibitors for pulmonary hypertension.The Cochrane database of systematic reviews · 2019Pooled it
- Pulmonary hypertension-targeted therapies in heart failure: A systematic review and meta-analysis.PloS one · 2018Pooled it
- Effects of sildenafil on symptoms and exercise capacity for heart failure with reduced ejection fraction and pulmonary hypertension (the SilHF study): a randomized placebo-controlled multicentre trial.European journal of heart failure · 2022Trial
- Persistent Pulmonary Hypertension in Corrected Valvular Heart Disease: Hemodynamic Insights and Long-Term Survival.Journal of the American Heart Association · 2021Trial
- The neurohormonal basis of pulmonary hypertension in heart failure with preserved ejection fraction.European heart journal · 2019Trial
- The β-Adrenergic Agonist Albuterol Improves Pulmonary Vascular Reserve in Heart Failure With Preserved Ejection Fraction.Circulation research · 2019Trial
- Reversing the pipeline: a 'human-first' multi-omics approach to cardiovascular discovery.Experimental & molecular medicine · 2026Review
- Worldwide Epidemiology of Pulmonary Hypertension Associated With Left Heart Disease.Cardiology discovery · 2026Review
- Integrating Resistant and Pulsatile Right Ventricular Load Improves Severity Assessment in Heart Failure Patients.JACC. Advances · 2026Article
- Article
- Extracorporeal Cardiopulmonary Resuscitation due to Left Atrial Myxoma With Severe Pulmonary Hypertension: A Challenging Combination.JACC. Case reports · 2026Article
- Pressure gradient vs. flow relationships in patients with symptomatic valvular aortic stenosis - PREFLOW.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Diagnosing post-capillary hypertension in patients with left heart disease: impact of new guidelines.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Subcutaneous Treprostinil in PH Associated With Left Heart Disease or Chronic Lung Disease.Pulmonary circulation · 2026Article
- Impact of Right Heart Catheterization and the 2022 ESC/ERS Definition of Pulmonary Hypertension in Patients With Mitral Regurgitation Undergoing Valve Repair/Replacement.Pulmonary circulation · 2026Article
- Evaluation of pulmonary hypertension in heart failure with preserved ejection fraction.Heart failure reviews · 2025Review
- The role of the bone morphogenetic protein receptor 2 pathway in group 2 pulmonary hypertension secondary to valvular heart disease.ERJ open research · 2025Article
46 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
27 authors at 12 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aims: We aimed to determine whether treatment with sildenafil improves outcomes of patients with persistent pulmonary hypertension (PH) after correction of valvular heart disease (VHD). Methods and results: The sildenafil for improving outcomes after valvular correction (SIOVAC) study was a multricentric, randomized, parallel, and placebo-controlled trial that enrolled stable adults with mean pulmonary artery pressure ≥ 30 mmHg who had undergone a successful valve replacement or repair procedure at least 1 year before inclusion. We assigned 200 patients to receive sildenafil (40 mg three times daily, n = 104) or placebo (n = 96) for 6 months. The primary endpoint was the composite clinical score combining death, hospital admission for heart failure (HF), change in functional class, and patient global self-assessment. Only 27 patients receiving sildenafil improved their composite clinical score, as compared with 44 patients receiving placebo; in contrast 33 patients in the sildenafil group worsened their composite score, as compared with 14 in the placebo group [odds ratio 0.39; 95% confidence interval (CI) 0.22-0.67; P < 0.001]. The Kaplan-Meier estimates for survival without admission due to HF were 0.76 and 0.86 in the sildenafil and placebo groups, respectively (hazard ratio 2.0, 95% CI = 1.0-4.0; log-rank P = 0.044). Changes in 6-min walk test distance, natriuretic peptides, and Doppler-derived systolic pulmonary pressure were similar in both groups. Conclusion: Treatment with sildenafil in patients with persistent PH after successfully corrected VHD is associated to worse clinical outcomes than placebo. Off-label usage of sildenafil for treating this source of left heart disease PH should be avoided. The trial is registered with ClinicalTrials.gov, number NCT00862043.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.