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            0 => "Pulmonary hypertension"
            1 => "Inoperable chronic thromboembolic pulmonary hypertension"
            2 => "Sildenafil"
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            0 => "Hipertensi&#243;n pulmonar"
            1 => "Hipertensi&#243;n pulmonar tromboemb&#243;lica cr&#243;nica y no quir&#250;rgica"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To assess the efficacy of treatment with sildenafil monotherapy in patients with pulmonary hypertension&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">An observational study was undertaken in 11 patients with pulmonary hypertension in functional class II or III who received treatment with sildenafil &#40;150 mg&#47;day&#41;&#46; Seven of the patients had inoperable chronic thromboembolic pulmonary hypertension and 4 had pulmonary arterial hypertension&#46; To assess treatment response&#44; the following parameters were assessed during follow-up at 3&#44; 6&#44; and 12 months&#58; exercise tolerance in the 6-minute walk test&#44; change in functional class&#44; and systolic pulmonary arterial pressure measured by echocardiography&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">We observed a significant improvement in exercise tolerance&#44; as shown by increased 6-minute walk distance after 3&#44; 6&#44; and 12 months of treatment &#40;increases of 20&#44; 67&#44; and 95 m&#44; respectively&#41;&#46; All patients showed an improvement in functional class&#46; The results of echocardiography did not reveal statistically significant differences in systolic pulmonary arterial pressure between baseline and 6 or 12 months of treatment&#46; No significant adverse effects were observed&#44; although sildenafil treatment was suspended in 1 patient due to persistent headache&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The results of this study confirm that sildenafil is an effective drug for the management of pulmonary arterial hypertension and inoperable chronic thromboembolic pulmonary hypertension both in the short term and medium to long term&#44; and that the drug is well tolerated and shows few side effects&#46;</p>"
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      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Valorar la eficacia del tratamiento con sildena-filo en monoterapia en pacientes con hipertensi&#243;n pulmonar &#40;HP&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio obser-vacional de 11 pacientes con HP en clases funcionales II y III&#44; a quienes se administr&#243; tratamiento con sildenafilo &#40;150 mg&#47;d&#237;a&#41;&#46; Siete presentaban HP tromboemb&#243;lica cr&#243;nica y no quir&#250;rgica y 4&#44; hipertensi&#243;n arterial pulmonar&#46; Para valo-rar la respuesta analizamos a los 3&#44; 6 y 12 meses los siguien-tes par&#225;metros&#58; tolerancia al esfuerzo mediante el test de la marcha de 6 min&#44; cambio de clase funcional y ecocardiogra-ma para valorar la presi&#243;n sist&#243;lica en la arteria pulmonar&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Encontramos una mejor&#237;a significativa de la tolerancia al esfuerzo&#44; con un incremento de la distancia ca-minada en 6 min&#44; a los 3&#44; 6 y 12 meses de tratamiento &#40;&#43;20&#44; &#43;67 y &#43;95 m&#44; respectivamente&#41;&#46; Todos los pacientes mejora-ron de clase funcional&#46; El seguimiento ecocardiogr&#225;fico no mostr&#243; diferencias estad&#237;sticamente significativas entre los valores basal y a los 6 y 12 meses de tratamiento de la pre-si&#243;n sist&#243;lica en la arteria pulmonar&#46; No observamos efectos adversos significativos&#44; aun cuando se retir&#243; el tratamiento con sildenafilo en un paciente por cefalea persistente&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los hallazgos de este estudio confirman que el sildenafilo es un f&#225;rmaco eficaz para el manejo de la hipertensi&#243;n arterial pulmonar y la HP tromboemb&#243;lica cr&#243;nica y no quir&#250;rgica&#44; tanto a corto como a medio-largo plazo&#44; con buena tolerancia y escasos efectos secundarios&#46;</p>"
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                          "colaboracion" => "for the Treprostinil study group"
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