Effects of transcatheter closure and Sildenafil on plasma brain natriuretic peptide in patients with ventricular septal defects combined with moderate-severe pulmonary artery hypertension

Objective To investigate the changes of plasma brain natriuretic peptide(BNP) concentration and mean pulmonary artery pressure(mPAP) in patients with ventricular septal defects(VSD) combined with moderate-severe pulmonary artery hypertension(PAH) after transcatheter closure and the influence of Sildenafil on them.Methods A total of 60 patients(≥18 years) with VSD combined with moderate-severe PAH hospitalized in our hospital between Jan 2008 and Aug 2012 were included in the study.They were divided into 3 groups randomly,20 in each group: group 1(treated with Sildenafil,20mg tid,),group 2(treated with Benazepril,7.5-20mg qd,) and group 3(no drug treatment).The plasma BNP concentration and mPAP were measured respectively before treatment,24 hours and 3months after transcatheter closure.Results Compared to the transcatheter closure before,the mPAP decreased and the plasma BNP concentration increased significantly in 24 hours after the procedure in all groups(all P 0.05).Compared with group 3,significant decrease in plasma BNP concentration and mPAP was observed in group 1and group 2 after 3-month drug treatment(all P 0.05) and the decrease in group 1 was greater than that in group 2.Conclusions The plasma BNP concentration and mPAP were decreased after transcatheter closure in adult VSD combined with moderate-severe PAH.The effect of Sildenafil is better than Benazepril in treating PAH after transcatheter closure.