Phosphodiesterase 5 Inhibitors

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Editorial

Aortic Stiffness and the Response to Phosphodiesterase-5 Inhibitors in Patients Receiving Treatment for Erectile Dysfunction: Predictive Role or an Epiphenomenon?

Erectile dysfunction (ED), a health problem with multifactorial pathogenesis and high prevalence, is directly correlated with patient age and is related to endothelial dysfunction and an increased risk of cardiovascular disease (CVD). Vascular endothelial dysfunction is currently considered to be the link between vasculogenic ED and cardiometabolic diseases, including hypertension, diabetes, and atherosclerosis.^, The association between ED and CVD has long been recognized, and studies suggest that ED may be an independent marker of CVD risk, including the presence of subclinical coronary artery disease in otherwise asymptomatic men.

In this context, the general use of type 5 phosphodiesterase inhibitors (iPDE-5) has led more patients with ED to seek medical help, providing an excellent opportunity for the identification and correction of possible cardiovascular risk factors. In addition to functional and structural vascular alterations in the systemic circulation that occur during ED, local microcirculatory disturbances and fibrosis are thought to contribute to the pathogenesis of ED.^, Moreover, penile endothelium-dependent microvascular function has been shown to improve after continuous use of sildenafil in hypertensive patients with ED.

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Original Article

Role of Aortic Stiffness in Predicting Response to Phosphodiesterase-5 Inhibitors in the Treatment of Erectile Dysfunction

Ömer Faruk Çiçek et al. Halil Ferat Öncel Remzi Salar

Abstract

Background:

It is known that aortic stiffness (AS) increases in patients with erectile dysfunction (ED). Phosphodiesterase type-5 (PDE-5) enzyme inhibitors are used in the treatment of ED, and patients’ responses to this treatment may vary.

Objectives:

We aimed to investigate the role of AS in predicting the response of patients planned to take PDE-5 enzyme inhibitors due to ED.

Methods:

A total of 96 male patients with ED were included in the study. The International Index of Erectile Function (IIEF) questionnaire was used to evaluate the presence and severity of ED and the response to treatment. Transthoracic echocardiography was used to evaluate AS.

Results:

There was a statistically significant difference between the aortic strain and aortic distensibility values of the study groups (p<0.001). The delta IIEF score had a high level of positive correlation with aortic strain (p<0.01, r=0.758) and a moderate level of positive correlation with aortic distensibility (p<0.01, r=0.574).

Conclusion:

We determined that in patients with ED, aortic strain and aortic distensibility measured non-invasively using transthoracic echocardiography are important parameters in predicting patients’ response to PDE-5 inhibitor therapy.

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Original Article

Long-Term Clinical and Hemodynamic Outcomes after Heart Transplantation in Patients Pre-Treated with Sildenafil

Sofia Lázaro Mendes et al. Nadia Moreira Manuel Batista Ana Rita Ferreira … Ana Vera Marinho David Prieto Rui Baptista Susana Costa Fatima Franco Mariano Pego Manuel de Jesus Antunes

Abstract

Background

Elevated pulmonary vascular resistance remains a major problem for heart transplant (HT) candidate selection.

Objective

This study sought at assess the effect of pre-HT sildenafil administration in patients with fixed pulmonary hypertension.

Methods

This retrospective, single-center study included 300 consecutive, HT candidates treated between 2003 and 2013, in which 95 patients had fixed PH, and of these, 30 patients were treated with sildenafil and eventually received a transplant, forming Group A. Group B included 205 patients without PH who underwent HT. Pulmonary hemodynamics were evaluated before HT, as well as 1 week after and 1 year after HT. Survival was compared between the groups. In this study, a p value < 0.05 was considered statistically significant.

Results

After treatment with sildenafil but before HT, PVR (-39%) and sPAP (-10%) decreased significantly. sPAP decreased after HT in both groups, but it remained significantly higher in group A vs. group B (40.3 ± 8.0 mmHg vs 36.5 ± 11.5 mmHg, p=0.022). One year after HT, sPAP was 32.4 ± 6.3 mmHg in group A vs 30.5 ± 8.2 mmHg in group B (p=0.274). The survival rate after HT at 30 days (97% in group A versus 96% in group B), at 6 months (87% versus 93%) and at one year (80% vs 91%) were not statistically significant (Log-rank p=0.063). After this first year, the attrition rate was similar among both groups (conditional survival after 1 year, Log-rank p=0.321).

Conclusion

In patients with severe PH pre-treated with sildenafil, early post-operative hemodynamics and prognosis are numerically worse than in patients without PH, but after 1 year, the medium to long-term mortality proved to be similar. (Arq Bras Cardiol. 2021; 116(2):219-226)

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Aortic Stiffness and the Response to Phosphodiesterase-5 Inhibitors in Patients Receiving Treatment for Erectile Dysfunction: Predictive Role or an Epiphenomenon?

Role of Aortic Stiffness in Predicting Response to Phosphodiesterase-5 Inhibitors in the Treatment of Erectile Dysfunction

Abstract

Background:

Objectives:

Methods:

Results:

Conclusion:

Long-Term Clinical and Hemodynamic Outcomes after Heart Transplantation in Patients Pre-Treated with Sildenafil

Abstract

Background

Objective

Methods

Results

Conclusion

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)