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Immediate- and late-hemodynamic coronary effects of tadalafil in men with erectile dysfunction and coronary artery disease

International Journal of Impotence Research volume 20, pages 168–172 (2008)Cite this article

Abstract

We investigated whether coronary flow reserve (CFR) can be modified by tadalafil, a long-acting phosphodiesterase 5 (PDE5) inhibitor, in patients with documented coronary artery disease (CAD). CFR was non-invasively evaluated in 12 men with a positive history for erectile dysfunction (ED) and angiographically documented CAD, in the distal portion of the left anterior descending coronary artery, free from critical stenosis, with contrast enhanced echocardiography at time zero (T0). Then, after 20 mg tadalafil was orally administered CFR measurement was repeated after 2 h (T1) and after 24 h (T2). Doppler curves suitable for the analysis were obtained in all patients (CFR feasibility: 100%). The peak diastolic velocity after adenosine infusion increased from 71.3±14.3 cm/s at T0 to 82.5±24.0 at T1 (P=NS) and to 89.5±21.1 at T2 (P=0.0010). CFR after tadalafil increased significantly from 2.6±0.3 at T0 to 3.1±0.7 at T1 (P=0.0078) and a further increment was found at T2 (3.5±0.9; P=0.0010 vs T0). Our study shows that oral administration of tadalafil exerts a long standing, potentially beneficial effect on coronary microvasculature in patients with ED.

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References

  1. Araujo AB, Johannes CB, Feldman HA, Derby CA, McKinlay JB . Relation between psychosocial risk factors and incident erectile dysfunction: prospective results from the Massachussets Male Aging Study. Am J Epidemiol 2000; 152: 533–541.

    Article  CAS  Google Scholar 

  2. Solomon H, Man JW, Wierzbicki AS, Jackson G . Relation of erectile dysfunction to angiographic coronary artery disease. Am J Cardiol 2003; 91: 230–231.

    Article  Google Scholar 

  3. Bortolotti A, Parazzini F, Colli E, Landoni M . The epidemiology of erectile dysfunction and its risk factors. Int J Androl 1997; 20: 323–334.

    Article  CAS  Google Scholar 

  4. Montorsi P, Montorsi F, Schulman C . Is erectile dysfunction the tip of the iceberg of a systemic vascular disorder? Eur Urol 2003; 44: 352–354.

    Article  Google Scholar 

  5. Gazzarusso C, Giordanetti S, De Amici E, Bertone G, Falcone C, Geroldi D et al. Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients. Circulation 2004; 110: 22–26.

    Article  Google Scholar 

  6. Montorsi P, Ravagnani PM, Galli S, Rotatori F, Veglia F, Briganti A et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006; 27: 2632–2639.

    Article  Google Scholar 

  7. Solomon H, Man JW, Jackson G . Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 2003; 89: 251–253.

    Article  CAS  Google Scholar 

  8. Kloner RA . Cardiovascular effects of the 3 phosphodiesterase-5 inhibitors approved for the treatment of erectile dysfunction. Circulation 2004; 110: 3149–3155.

    Article  Google Scholar 

  9. Galiè N, Ghofrani HA, Torbicki A, Barst RJ, Rubin LJ, Badesh D et al. Sildenafil citrate therapy for pulmonary arterial hypertension. N Engl J Med 2005; 353: 2148–2157.

    Article  Google Scholar 

  10. Jackson G, Benjamin N, Jackson N, Allen MJ . Effects of sildenafil citrate on human hemodynamics. Am J Cardiol 1999; 83: 13C–20C.

    Article  CAS  Google Scholar 

  11. Cheitlin MD, Hutter Jr AM, Brindis RG, Ganz P, Kaul S, Russel Jr RO et al. ACC/AHA expert consensus document. Use of sildenafil (Viagra) in patients with cardiovascular disease. American College of Cardiology/American Heart Association. J Am Coll Cardiol 1999; 33: 273–282.

    Article  CAS  Google Scholar 

  12. Herrmann HC, Chang G, Klugherz BD, Mahoney PD . Hemodynamic effects of sildenafil in men with severe coronary artery disease. N Engl J Med 2000; 342: 1622–1626.

    Article  CAS  Google Scholar 

  13. Gillies HC, Roblin D, Jackson G . Coronary and systemic hemodynamic effects of sildenafil citrate: from basic science to clinical studies in patients with cardiovascular disease. Int J Cardiol 2002; 86: 131–141.

    Article  Google Scholar 

  14. Kloner RA, Mitchell M, Emmick JT . Cardiovascular effects of tadalafil. Am J Cardiol 2003; 92 (9A): 37M–46M.

    Article  CAS  Google Scholar 

  15. Rosano GMC, Aversa A, Vitale C, Fabbri A, Fini M, Spera G . Chronic treatment with tadalafil improves endothelial function in men with increased cardiovascular risk. Eur Urol 2005; 47: 214–222.

    Article  CAS  Google Scholar 

  16. Caiati C, Montaldo C, Zedda N, Bina A, Iliceto S . New noninvasive method for coronary flow reserve assessment. Contrast-enhanced transthoracic second harmonic echo Doppler. Circulation 1999; 99: 771–778.

    Article  CAS  Google Scholar 

  17. Caiati C, Montaldo C, Zedda N, Montisci R, Ruscazio M, Lai G et al. Validation of a new noninvasive method (contrast-enhanced transthoracic second harmonic echo Doppler) for the evaluation of coronary flow reserve: comparison with intracoronary Doppler flow wire. J Am Coll Cardiol 1999; 34: 1193–1200.

    Article  CAS  Google Scholar 

  18. Rosano GMC, Marazzi G, Patrizi R, Cerquetani E, Vitale C, Volterrani M et al. Comparison of trimetazidine plus sildenafil to chronic nitrates in the control of myocardial ischemia during sexual activity in patients with coronary artery disease. Am J Cardiol 2005; 95: 327–331.

    Article  CAS  Google Scholar 

  19. Montisci R, Chen L, Ruscazio M, Colonna P, Cadeddu C, Caiati C et al. Non-invasive coronary flow reserve is correlated with microvascular integrity and myocardial viability after primary angioplasty in acute myocardial infarction. Heart 2006; 92: 1113–1118.

    Article  CAS  Google Scholar 

  20. Tona F, Caforio AL, Montisci R, Angelini A, Ruscazio M, Gambino A et al. Coronary flow reserve by contrast-enhanced echocardiography: a new noninvasive diagnostic tool for cardiac allograft vasculopathy. Am J Transplant 2006; 6: 998–1003.

    Article  CAS  Google Scholar 

  21. Tona F, Caforio AL, Montisci R, Gambino A, Angelini A, Ruscazio M et al. Coronary flow velocity pattern and coronary flow reserve by contrast-enhanced transthoracic echocardiography predict long-term outcome in heart transplantation. Circulation 2006; 114: I49–I55.

    Article  Google Scholar 

  22. Halcox JPJ, Nour KRA, Zalos G, Mincemoyer RA, Waclawiw M, Rivera CE et al. The effects of sildenafil on human vascular function, platelet activation, and myocardial ischemia. JACC 2002; 40: 1232–1240.

    Article  CAS  Google Scholar 

  23. Dietz U, Tries HP, Merkle W, Jaursch-Hancke C, Lambertz H . Coronary artery flow reserve in diabetics with erectile dysfunction using sildenafil. Cardiovasc Diabetol 2003; 2: 8.

    Article  Google Scholar 

  24. Avogaro A, Toffolo G, Kiwanuka E, de Kreutzenberg SV, Tessari P, Cobelli C . -arginine-nitric oxide kinetics in normal and type 2 diabetic subjects: a stable-labelled 15N arginine approach. Diabetes 2003; 52: 795–802.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Ellen Murphy for her collaboration in the drafting of this work and Luigi Salmaso for statistical analysis.

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Authors and Affiliations

  1. Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy

    F Bellotto, M Ruscazio, G Bonanni, R Montisci, A Cutolo, C Sarais, T Setzu, A Borrini & S Iliceto

  2. Department of Surgical and Medical Sciences, University of Padova, Padova, Italy

    G Bonanni

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  1. F Bellotto
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  2. M Ruscazio
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  3. G Bonanni
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  4. R Montisci
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  5. A Cutolo
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  6. C Sarais
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  7. T Setzu
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  8. A Borrini
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  9. S Iliceto
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Correspondence to F Bellotto.

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Bellotto, F., Ruscazio, M., Bonanni, G. et al. Immediate- and late-hemodynamic coronary effects of tadalafil in men with erectile dysfunction and coronary artery disease. Int J Impot Res 20, 168–172 (2008). https://doi.org/10.1038/sj.ijir.3901592

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  • DOI: https://doi.org/10.1038/sj.ijir.3901592

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