Original ArticleHemodynamic Response to Sildenafil in Patients With Decompensated Congestive Heart Failure Can Be Predicted by Deceleration Time of Transmitral FlowMorisawa, Daisuke MD*; Hirotani, Shinichi MD, PhD*; Sugahara, Masataka MD*; Fukui, Miho MD*; Ando, Tomotaka MD*; Naito, Yoshiro MD, PhD*; Mano, Toshiaki MD, PhD*; Ishihara, Masaharu MD, PhD†; Masuyama, Tohru MD, PhD*Author Information *Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan; and †Department of Internal Medicine, Division of Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan. Reprints: Shinichi Hirotani, MD, PhD, Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan (e-mail: email@example.com). The authors report no conflicts of interest. Received July 25, 2014 Accepted September 16, 2014 Journal of Cardiovascular Pharmacology: January 2015 - Volume 65 - Issue 1 - p 72-79 doi: 10.1097/FJC.0000000000000168 Buy Metrics Abstract Aim: How sildenafil acutely provides hemodynamic alterations in patients with decompensated congestive heart failure remains unknown. The aim of this study was to investigate whether myocardial and/or hemodynamic conditions affect hemodynamic response to sildenafil in patients with decompensated heart failure. Methods and Results: Twenty-five consecutive patients with decompensated congestive heart failure were enrolled. The patients underwent echocardiography before and 1 hour after a single oral administration of sildenafil (20 mg). Sildenafil decreased pulmonary vascular resistance by 24% (P < 0.05), and increased left ventricular (LV) time–velocity integral by 17% (P < 0.05). Alteration of the ratio of peak velocity of early LV filling to early diastolic myocardial velocity (E/E′), an indicator of LV filling pressure, following administration of sildenafil, negatively associated with the deceleration time of early filling wave (DcT) at baseline. Patients with baseline DcT ≥200 milliseconds (n = 11) exhibited E/E′ increase, whereas patients with baseline DcT <200 milliseconds (n = 14) exhibited E/E′ decrease. Conclusions: Administration of sildenafil elevated LV filling pressure in decompensated heart failure patients with shortened deceleration time of early diastolic transmitral flow. © 2015 by Lippincott Williams & Wilkins.