The Effect of Cilostazol on Right Heart Function and Pulmonary Pressure

Abstract

Cilostazol is a PDE3 inhibitor and used to treat peripheral arterial disease. There are few reports on the influence of cilostazol on heart. The aim of this study was to assess this effect on right ventricular function and pulmonary artery pressure. Forty patients with normal left and right ventricular ejection fraction and mild or moderate pulmonary artery hypertension were enrolled in the study. Right ventricular function was assessed by tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), tissue Doppler imaging (TDI), and two-dimensional speckle-tracking echocardiography (2D-STE) before and after oral administration of cilostazol. Also pulmonary artery pressure assessed before and after administration of cilostazol. After cilostazol administration, there were significant increases in the TAPSE (1.9±0.3cm vs. 2.2±0.3cm, P<0.001). Peak longitudinal strain (-18.7±4.5% vs. -21.3 ±3.7%, P=0.001), isovolumetric acceleration (IVA) (176.6±62.7cm/sec(2) vs. 200.6±61.9cm/sec(2) , P=0.025), right ventricular FAC increased significantly (37.6±8.0% vs. 41.5±8.9%, P<0.001). Pulmonary artery pressure decreased significantly (39.9±7.9 vs. 36.6±5.5mmHg, P=0.001) after cilostazol administration. Our study demonstrated that cilostazol improved right ventricular systolic function and reduced pulmonary artery pressure.