Do Phosphodiesterase 5A Inhibitors Improve Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease (COPD) and Pulmonary Hypertension?

Do Phosphodiesterase 5A Inhibitors Improve Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease and Pulmonary Hypertension?

The investigators hypothesise that phosphodiesterase 5A inhibitors will improve exercise capacity in those with Chronic Obstructive Pulmonary Disease and secondary pulmonary hypertension.

Inclusion Criteria:

• COPD
• Forced expiratory volume in 1 second (FEV1) <80% (FEV1/FVC <0.70)
• Right ventricular systolic pressure (RVSP) > 30 mmHg or Pulmonary Acceleration time <120 ms

Exclusion Criteria:

• Pulmonary stenosis or echo left ventricular outflow tract obstruction

• Left ventricular ejection fraction < 45%

• Patients taking nitrates, nicorandil or doxazosin.

• Drug contraindications:

  • Systolic Blood Pressure <90 mmHg
  • recent stroke
  • unstable angina
  • past history of non arteritic anterior ischaemic optic neuropathy