Phosphodiesterase type 5 inhibitors (PDE5i) have been used to treat erectile dysfunction and pulmonary arterial hypertension but could long-term, continuous administration of these agents provide effective cardiac protection? Previous studies in humans have been inconclusive. In this study published in the journal BMC Medicine, researchers looked at 24 randomized, placebo-controlled trials to see what kind of effect PDE5i had on cardiac morphology and function. Based on these studies, they were able to deduce the following regarding PDE5i use: 1) In patients with moderate to severe left ventricular hypertrophy (LVH), PDE5i exerts an anti-remodeling effect on cardiac geometry; 2) PDE5i improves cardiac performance; 3) no major changes were seen in hemodynamic parameters; and 4) PDE5i use appeared to be safe. The most common adverse effects were headache, flushing, epistaxis, and gastric symptoms. Researchers conclude that given the results of this study, more clinical trials need to be conducted on the long-term effects of continuous PDE5i administration, with the ideal target population being patients with heart failure and LVH. Since gender data is limited, a trial with sex-specific response is necessary.
The myocardial effects of phosphodiesterase type 5 inhibitors (PDE5i) have recently received consideration in several preclinical studies. The risk/benefit ratio in humans remains unclear.