Phosphodiesterase type 5 inhibition may reduce diastolic function in women with ischemia but no obstructive coronary artery disease

Journal of Medical Case Reports
Michael D NelsonC Noel Bairey Merz

Abstract

Ischemia, in the absence of obstructive coronary artery disease, is prevalent in women, and associated with increased risk for major cardiovascular events. Coronary microvascular dysfunction is prevalent in these patients, and associated with impaired diastolic function. Despite our general understanding, however, optimal treatment of this cohort remains elusive. To address this knowledge gap, we performed an open-label treatment trial to assess whether phosphodiesterase type 5 inhibition improves coronary microvascular perfusion and diastolic function in women with signs and symptoms of ischemia but no evidence of obstructive coronary artery disease. Left ventricular morphology and function, along with myocardial perfusion reserve index, were assessed by contrast-enhanced cardiac magnetic resonance imaging. A total of five women enrolled of which four completed the trial, while one was withdrawn by the investigators after developing dyspnea 1 week after treatment. Her symptoms resolved after cessation of the study medication. In contrast to our hypothesis, phosphodiesterase type 5 inhibition reduced the rate of circumferential strain in diastole in all four women who completed the trial (that is, diastolic dysfunction). This i...Continue Reading

References

Sep 20, 2012·Circulation. Heart Failure·Margaret M RedfieldUNKNOWN Heart Failure Clinical Research Network
Jul 22, 2014·Annals of Neurology·Doris G LeungKathryn R Wagner
Feb 14, 2015·JACC. Cardiovascular Imaging·Mark A MarinescuJamieson M Bourque

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Citations

Aug 11, 2017·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Michael D Nelson

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Clinical Trials Mentioned

NCT00832702

Software Mentioned

OsiriX

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