Autonomic cerebral vascular response to sildenafil in diabetic patient

Al-Amran, Fadhil G.; Zwain, Akeel Amh; Hadi, Najah R; Al-Mudhaffer, Ahmed M

doi:10.1186/1758-5996-4-2

Cited by 16 publications

(23 citation statements)

References 23 publications

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“…This concurs with Mandosi et al (16) who found out that sildenafil exerted a beneficial effect on glycometabolic control in type 2 diabetes by increasing insulin sensitivity (17). Moreover, the combination of sildenafil and insulin may offer an improved cerebrovascular response (18), due to its relaxation action on corpora cavernosa.…”

Section: Resultssupporting

confidence: 86%

Sildenafil alters biogenic amines and increases oxidative damage in brain regions of insulin-hypoglycemic rats

et al. 2019

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The aim of the present study was to determine the effect of sildenafil on dopamine, 5-hydroxyindol acetic acid (5-HIAA) and selected biomarkers of oxidative stress in the brain of hypoglycemic rats. The animals were treated intraperitoneally as follows: group 1 (control), saline solution; group 2, insulin (10 U per rat or 50 U kg−1); group 3, insulin + single dose of sildenafil (50 U kg−1 + 50 mg kg–1); group 4, insulin + three doses of sildenafil every 24 hours (50 U kg−1 + 50 mg kg−1). In groups 2, 3 and 4, insulin was administered every 24 hours for 10 days. Blood glucose was measured after the last treatment. On the last day of the treatment, the animals´ brains were extracted to measure the levels of oxidative stress markers [H2O2, Ca2+,Mg2+-ATPase, glutathione and lipid peroxidation (TBARS)], dopamine and 5-HIAA in the cortex, striatum and cerebellum/medulla oblongata by validated methods. The results suggest that administration of insulin in combination with sildenafil induces hypoglycemia and hypotension, enhances oxidative damage and provokes changes in the brain metabolism of biogenic amines. Administration of insulin and sildenafil promotes biometabolic responses in glucose control, namely, it induces hypoglycemia and hypotension. It also enhances oxidative damage and provokes changes in the brain metabolism of biogenic amines.

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Section: Resultssupporting

confidence: 86%

Sildenafil alters biogenic amines and increases oxidative damage in brain regions of insulin-hypoglycemic rats

et al. 2019

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“…Of note, this study is an extension to our previous article published in this journal where modulatory effect of sildenafil on middle cerebral artery (MCA) was investigated in the same subjects. 17 …”

Section: Methodsmentioning

confidence: 99%

Sildenafil dilates ophthalmic artery in type 2 diabetic patients

2013

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Background:Conflicting reports exist on the effect of sildenafil on ophthalmic artery blood flow; many visual disturbances due to vascular insult were reported with the use of sildenafil in diabetic patients like nonarteritic ischemic optic neuropathy.Objectives:The present work aimed to investigate whether sildenafil modulates ophthalmic artery vasoreactivity in patients with type 2 diabetes mellitus. Literature reports on this aspect are lacking.Methods:A total of 35 male subjects were enrolled in this study, 18 with type 2 diabetes mellitus matched with 17 normal individuals. Ophthalmic artery was insonated through a transorbital window using colored Doppler equipment with transcranial Doppler facility. Ophthalmic artery reactivity was assessed using breath holding/hyperventilation test, before and after giving 50 mg oral sildenafil.Results:It was found that in both normal subjects and diabetic patients, sildenafil increased baseline control of mean flow velocity of ophthalmic artery significantly (p < 0.05), breath holding caused a decrease of MFVopa (p < 0.05), and subsequent hyperventilation caused increase of MFVopa (p < 0.05). There was no statistically significant change in breath holding index and full range of vasodilatation of ophthalmic artery (p > 0.05) after sildenafil, in normal and diabetic groups. There was a significant increase of resistive index of ophthalmic artery flow in diabetic patients compared with that of normal subject (p < 0.05). Sildenafil decreased resistive index of ophthalmic artery flow significantly only in diabetic patients (p < 0.05).Conclusion:Sildenafil increased MFVopa, but had no significant effect on vasoreactivity of ophthalmic artery; sildenafil decreased resistive index only in type 2 diabetic patients.

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“…Pulsatility index and resistive index may reflect the compliance of the vessel and therefore, high PI and/or RI may indicate increase vascular resistance and increase in arterial stiffness [15,16]. Previous studies showed that diabetic patients have higher resistive index than normal population and this may increase micro-and macro-vascular complications [32].…”

Section: Discussionmentioning

confidence: 99%

“…To obtain MCA spectral wave form, probe is directed backward and slightly upward. The pulse wave Doppler sample volume was adjusted to maximum level in the device and the power 75 MW for identification and localization of middle cerebral artery spectral waveform [32,33]. To recognize the waveform of middle cerebral artery, the waves are above zero line in spectral wave display screen.…”

Section: Methodsmentioning

confidence: 99%

Effects of metformin on middle cerebral artery flow velocity in newly diagnosed type 2 Diabetic patients

2016

AJBM

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Type 2 diabetes mellitus is a major cause of cerebrovascular disease. Risk of ischemic stroke is higher in diabetic patients and it is about 2-6 times that in normal population. Atherosclerotic lesions happen early in the disease and patients with type 2 diabetes mellitus. Transcranial Doppler can be used for examination of cerebral arteries and it can detect early atherosclerotic changes. Metformin an old oral anti-diabetic drug but still cornerstone in the treatment guidelines of type 2 diabetes mellitus. It improves endothelial function with preferable cardiovascular effects. Twenty patients were recruited for the study. Transcranial Doppler examination done for all patients before initiation of treatment. Patients received metformin for twelve weeks and they were re-examined with transcranial Doppler. The data of present study showed that a highly significant increase in diastolic velocity and mean flow velocity after treatment with significant reduction in pulsatility index and resistive index. In conclusion, metformin treatment increases cerebral diastolic flow velocity with reduction in vascular resistance in patients with type 2 diabetes.

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Autonomic cerebral vascular response to sildenafil in diabetic patient

Cited by 16 publications

References 23 publications

Sildenafil alters biogenic amines and increases oxidative damage in brain regions of insulin-hypoglycemic rats

Sildenafil alters biogenic amines and increases oxidative damage in brain regions of insulin-hypoglycemic rats

Sildenafil dilates ophthalmic artery in type 2 diabetic patients

Effects of metformin on middle cerebral artery flow velocity in newly diagnosed type 2 Diabetic patients

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