Study of Sildenafil in Advanced Heart Failure.
Study of Sildenafil in Advanced Heart Failure.
Despite advances in medical therapy for patients with heart failure, one-third of patients
 remain limited by fatigue and shortness of breath.

 Our previous study concluded that one dose of sildenafil (Viagra) lead to an improvement in
 heart pressure and exercise capacity.

 Currently sildenafil is not FDA approved for the treatment of heart failure.

 The purpose of this study is to determine if treatment with sildenafil for 12 weeks in
 patients with heart failure can improve exercise capacity and quality of life in people with
 heart failure.
This study will compare two groups of patients. One group will receive sildenafil and the
 other group will receive a placebo (a pill which looks like sildenafil, but contains no
 medication).

 Patients will undergo a heart catheterization, echocardiogram and exercise stress test.
 Patients will then take study medication for 12 weeks. A repeat heart catheterization,
 echocardiogram and exercise stress test will then be performed.
Inclusion Criteria:

 Age >18 years Ejection fraction <40% Heart failure limited by fatigue and shortness of
 breath Pulmonary artery hypertension

 Exclusion Criteria:

 Patients taking the following medications: nitroglycerine pill/patch/paste, isordil, Imdur,
 antifungal agents and certain antidepressants.

 Patients with a history of optic neuropathy or unexplained visual impairment. Patients with
 anemia.

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