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Phosphodiesterase type 5 inhibition does not reverse endothelial dysfunction in patients with coronary heart disease.
- Source :
-
Heart (British Cardiac Society) [Heart] 2006 Feb; Vol. 92 (2), pp. 170-6. Date of Electronic Publication: 2005 Apr 29. - Publication Year :
- 2006
-
Abstract
- Objectives: To investigate whether sildenafil citrate, a selective phosphodiesterase type 5 inhibitor, may improve endothelial vasomotor and fibrinolytic function in patients with coronary heart disease.<br />Design: Randomised double blind placebo controlled crossover study.<br />Patients and Methods: 16 male patients with coronary heart disease and eight matched healthy men received intravenous sildenafil or placebo. Bilateral forearm blood flow and fibrinolytic parameters were measured by venous occlusion plethysmography and blood sampling in response to intrabrachial infusions of acetylcholine, substance P, sodium nitroprusside, and verapamil.<br />Main Outcome Measures: Forearm blood flow and acute release of tissue plasminogen activator.<br />Results: Mean arterial blood pressure fell during sildenafil infusion from a mean (SEM) of 92 (1) to 82 (1) mm Hg in patients and from 94 (1) to 82 (1) mm Hg in controls (p < 0.001 for both). Sildenafil increased endothelium independent vasodilatation with sodium nitroprusside (p < 0.05) but did not alter the blood flow response to acetylcholine or verapamil in patients or controls. Substance P caused a dose dependent increase in plasma tissue plasminogen activator antigen concentrations (p < 0.01) that was unaffected by sildenafil in either group.<br />Conclusions: Sildenafil does not improve peripheral endothelium dependent vasomotor or fibrinolytic function in patients with coronary heart disease. Phosphodiesterase type 5 inhibitors are unlikely to reverse the generalised vascular dysfunction seen in patients with coronary heart disease.
- Subjects :
- 3',5'-Cyclic-GMP Phosphodiesterases
Coronary Disease physiopathology
Cross-Over Studies
Cyclic Nucleotide Phosphodiesterases, Type 5
Double-Blind Method
Endothelium, Vascular physiopathology
Fibrinolysis drug effects
Forearm blood supply
Humans
Male
Middle Aged
Phosphoric Diester Hydrolases
Purines
Sildenafil Citrate
Sulfones
Tissue Plasminogen Activator metabolism
Coronary Disease drug therapy
Endothelium, Vascular drug effects
Phosphodiesterase Inhibitors therapeutic use
Piperazines therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1468-201X
- Volume :
- 92
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Heart (British Cardiac Society)
- Publication Type :
- Academic Journal
- Accession number :
- 15863522
- Full Text :
- https://doi.org/10.1136/hrt.2004.059683