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Type: Artigo de periódico
Title: Tadalafil-induced Improvement In Left Ventricular Diastolic Function In Resistant Hypertension.
Author: Santos, Rodrigo C
de Faria, Ana Paula C
Barbaro, Natália R
Modolo, Rodrigo
Ferreira-Melo, Silvia E
Matos-Souza, José R
Coelho, Otávio R
Yugar-Toledo, Juan C
Fontana, Vanessa
Calhoun, David
Moreno, Heitor
Abstract: Left ventricular hypertrophy and diastolic dysfunction (LVDD) remain highly frequent markers of cardiac damage and risk of progression to symptomatic heart failure, especially in resistant hypertension (RHTN). We have previously demonstrated that administration of sildenafil in hypertensive rats improves LVDD, restoring phosphodiesterase type 5 (PDE-5) inhibition in cardiac myocytes. We hypothesized that the long-acting PDE-5 inhibitor tadalafil may be clinically useful in improving LVDD in RHTN independently of blood pressure (BP) reduction. A single blinded, placebo-controlled, crossover study enrolled 19 patients with both RHTN and LVDD. Firstly, subjects received tadalafil (20 mg) for 14 days and after a 2-week washout period, they received placebo orally for 14 days. Patients were evaluated by office BP and ambulatory BP monitoring (ABPM), endothelial function (FMD), echocardiography, plasma brain natriuretic peptide (BNP-32), cyclic guanosine monophosphate (cGMP) and nitrite levels. No significant differences were detected in BP measurements. Remarkably, at least four echocardiographic parameters related with diastolic function improved accompanied by decrease in BNP-32 in tadalafil use. Although increasing cGMP, tadalafil did not change endothelial function or nitrites. There were no changes in those parameters after placebo. The current findings suggest that tadalafil improves LV relaxation through direct effects PDE-5-mediated in the cardiomyocytes with potential benefit as an adjunct to treat symptomatic subjects with LVDD such as RHTN patients.
Subject: Aged
Blood Pressure
Cross-over Studies
Cyclic Gmp
Drug Resistance
Hypertrophy, Left Ventricular
Middle Aged
Natriuretic Peptide, Brain
Phosphodiesterase 5 Inhibitors
Single-blind Method
Ventricular Dysfunction, Left
Ventricular Function, Left
Rights: fechado
Identifier DOI: 10.1007/s00228-013-1611-8
Date Issue: 2014
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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