Coronary artery flow reserve in diabetics with erectile dysfunction using sildenafil

Dietz, Ulrich; Tries, Hans-Peter; Merkle, Walter; Jaursch-Hancke, Cornelia; Lambertz, Heinz

doi:10.1186/1475-2840-2-8

Cited by 8 publications

(1 citation statement)

References 31 publications

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“… 28 However, coronary flow reserve did not significantly improve following an acute administration of sildenafil in 21 diabetic men with known erectile dysfunction and asymptomatic CAD. 29 …”

Section: Pde5 Inhibitors and Cardiovascular Disease In Diabetesmentioning

confidence: 99%

The efficacy of PDE5 inhibitors in diabetic patients

Święcicka

2022

Andrology

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Background: Phosphodiesterase 5 inhibitors (PDE5i), since their introduction in the late 1990s, have proven their efficacy in treating several conditions, predominantly pulmonary hypertension and erectile dysfunction where they remain the first-line therapeutic option. However, in the recent years, growing evidence from both animal and human studies has emerged to suggest the additional benefits of PDE5i in cardiovascular and metabolic disorders. This is of specific interest to the diabetes population where prevalent cardiovascular disease and metabolic dysregulation significantly contribute to the increased morbidity and mortality. Objectives:To examine the available data on the non-standard, pleiotropic effects of PDE5i in patients with diabetes mellitus. Materials and methods:The review of the published background research, preclinical studies and clinical trials. Results:In human studies, PDE5 inhibition appeared to be associated with reduced cardiovascular mortality and overall improved clinical outcomes in those with established cardiovascular disease. PDE5i were also consistently found to reduce albuminuria in subjects with diabetic nephropathy. Furthermore, animal data suggest a plausible effect of this group of medication on sensory function and neuropathic symptoms in diabetic neuropathy as well as improved wound healing. A decrease in insulin resistance and augmentation of beta cell function seen in preclinical studies has not been consistently demonstrated in human trials. Discussion and conclusion:In animal models, PDE5 inhibition appears to decrease oxidative stress and reduce some of the micro-and macrovascular complications associated with diabetes. However, data from human trials are limited and largely inconsistent, highlighting the need for adequately powered, randomised-controlled trials in diabetic cohorts in order to fully assess the benefits of PDE5i in this group of patients.

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Section: Pde5 Inhibitors and Cardiovascular Disease In Diabetesmentioning

confidence: 99%

The efficacy of PDE5 inhibitors in diabetic patients

Święcicka

2022

Andrology

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Effect of Phosphodiesterase Type 5 Inhibition on Microvascular Coronary Dysfunction in Women: A Women's Ischemia Syndrome Evaluation (WISE) Ancillary Study

Denardo

Wen

Handberg

et al. 2011

Clinical Cardiology

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SUMMARY Background Microvascular coronary dysfunction (MCD) is associated with symptoms, signs of ischemia, and adverse outcomes in women without macrovascular obstructive coronary artery disease (M-CAD). Although, MCD can be quantified using coronary flow reserve (CFR), treatment is poorly defined. Hypothesis Phosphodiesterase type 5 (PDE-5) inhibition acutely improves MCD in these women. Methods The subjects were 23 symptomatic women (age 54±11 years) participating in an ancillary study of the Women’s Ischemia Syndrome Evaluation (WISE) with baseline CFR ≤3.0 (Doppler flow wire and intracoronary adenosine) and without M-CAD. CFR was re-measured 45 minutes after PDE-5 inhibition (100 mg oral sildenafil). The primary measure of interest was change in CFR adjusted for baseline variables. Results The relationship between log2 transformed CFR post–PDE-5 inhibition (adjusted) and baseline was different from the line of identity (slope: 0.55 vs. 1.0, P=0.008; intercept: 0.73 vs. 0.0, P=0.01), indicating that PDE-5 inhibition improves CFR and the lower the baseline CFR, the greater the response. Among women with baseline CFR ≤2.5 (N=11), CFR increased from 2.1±0.2 to 2.7±0.6 (P=0.006). For women with baseline CFR >2.5 (N=12), CFR did not change (3.1±0.3 to 3.0±0.6; P=0.70). Conclusions For women with symptoms and signs of ischemia and no M-CAD, PDE-5 inhibition is associated with acute improvement in CFR and the effect concentrates among those with CFR ≤2.5. If these acute effects are sustained, then PDE-5 inhibition would provide a rational strategy for management of MCD in symptomatic women without M-CAD. The longer-term effects warrant study in a randomized trial using a sustained acting PDE-5 inhibitor.

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Molecular processing of sildenafil in endothelial function: potential applications in cardiovascular diseases

Alsafwah

Katz

2004

Sildenafil

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Coronary artery flow reserve in diabetics with erectile dysfunction using sildenafil

Abstract: Background: Diabetics with erectile dysfunction have a high prevalence of microvascular disturbance of the coronary circuit as measured by coronary flow reserve (CFR).

Cited by 8 publications

References 31 publications

The efficacy of PDE5 inhibitors in diabetic patients

The efficacy of PDE5 inhibitors in diabetic patients

Effect of Phosphodiesterase Type 5 Inhibition on Microvascular Coronary Dysfunction in Women: A Women's Ischemia Syndrome Evaluation (WISE) Ancillary Study

Molecular processing of sildenafil in endothelial function: potential applications in cardiovascular diseases

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