Tadalafil improves quality of life and exercise tolerance in idiopathic pulmonary arterial hypertension

Affuso, Flora; Palmieri, Emiliano Antonio; Conza, Pasquale Di; Guardasole, Vincenzo; Fazio, Serafino

doi:10.1016/j.ijcard.2005.08.051

Cited by 36 publications

(25 citation statements)

References 9 publications

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“…The newer compounds vardenafil and tadalafil are currently undergoing evaluation for their use in pulmonary arterial hypertension and other cardiovascular and pulmonary diseases. [104][105][106]. Sildenafil use in pulmonary hypertension-1 is a double-blind, randomized, controlled trial, which investigated the use of sildenafil in the management of pulmonary hypertension associated with connective tissue diseases.…”

Section: Phosphodiesterase-5 Inhibitorsmentioning

confidence: 99%

Recent Advances in the Treatment of Systemic Sclerosis

Bournia

Vlachoyiannopoulos

Selmi

et al. 2009

Clinic Rev Allerg Immunol

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Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by widespread vascular injury and progressive fibrosis of the skin and internal organs. The involvement of internal organs results in significant morbidity and mortality of SSc patients with cardiopulmonary involvement being the leading cause of SSc-related deaths. The management of SSc patients remains a challenge because therapeutic options are rather limited and no therapy has definitively shown a disease-modifying effect. A significant progress that has recently been made in the understanding of the SSc pathogenesis contributed to the introduction of new therapeutic options. Preliminary clinical studies have yielded promising results for mycophenolate mofetil, anti-CD20 antibodies, and stem-cell in the treatment of SSc. Multicenter cohort studies help understand the natural history of SSc, which leads to improvement in the care of SSc patients. The major objective of those studies is to establish the screening strategies for early diagnosis and, subsequently, to introduce appropriate management concerning specific organ involvement in SSc as well as to formulate specific treatment recommendations.

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Section: Phosphodiesterase-5 Inhibitorsmentioning

confidence: 99%

Recent Advances in the Treatment of Systemic Sclerosis

Bournia

Vlachoyiannopoulos

Selmi

et al. 2009

Clinic Rev Allerg Immunol

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“…The case studies have demonstrated the potential role of tadalafil in patients with severe pulmonary hypertension. 53,54 …”

Section: Role Of Pde-5 Inhibitors In Pulmonary Hypertensionmentioning

confidence: 99%

“…Affuso et al 53 Case report of an idiopathic pulmonary hypertension patient treated with 20 mg of tadalafil every other day for 6 months who had a drop in pulmonary artery pressure from 100 to 76 mm Hg.…”

Section: Study Findingsmentioning

confidence: 99%

Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

Al-Ameri

Kloner

2009

Int J Impot Res

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The phosphodiesterase type 5 (PDE-5) inhibitors are effective in treating erectile dysfunction (ED). ED and heart failure (HF) share similar risk factors, and commonly present together. This association has led to questions ranging from the safety and efficacy of PDE-5 inhibitors in HF patients to a possible role for this class of medication to treat HF patients with or without ED. In addition to endothelial dysfunction, there are causes of ED specific to patients with HF including low exercise tolerance, depression and HF medications. Before treating HF patients with PDE-5 inhibitors, patients should be assessed for their risk of a cardiac event during sexual activity. PDE-5 inhibitors are safe and effective in treating ED in HF patients. An improvement in erectile function by PDE-5 inhibitors was associated with an improvement in quality of life and reduction in depression. Several studies demonstrated the effect of PDE-5 inhibitors on HF per se. PDE-5 inhibitors improved endothelial dysfunction, increased exercise tolerance, decreased pulmonary vascular resistance and pulmonary artery pressure, and increased cardiac index. Several mechanisms whereby PDE-5 inhibitors improve HF have been proposed. PDE-5 inhibitors already have a role in treating primary pulmonary hypertension; however additional studies are needed to determine if they will become a standard therapy for HF patients.

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“…nitric oxide; exercise; tadalafil; adrenocorticotropin; cortisol THE SECRETION OF SYSTEMIC stress mediators (e.g., catecholamines, pituitary and adrenal hormones) increases after exercise depending on type, intensity, and duration of performed physical activity, individual characteristics, and associated psychological and metabolic stressors (7,17,21,29,36,48). In addition, many prohibited (e.g., anabolic hormones, glucocorticoids) and nonprohibited [e.g., nonsteroidal anti-inflammatory drugs, phosphodiesterases type 5 (PDE5) inhibitors (PDE5i), amino acids] substances, largely used or abused by athletes, have been shown to influence exercise performances and/or endocrine pathways at rest and during exercise (9 -11, 13, 19, 22).The PDE5i (e.g., sildenafil, tadalafil) widely used to treat erectile dysfunction in males have been shown to differently influence exercise capacity and/or energy metabolism during exercise, both in subjects affected by cardiopulmonary diseases and in healthy individuals, depending on the type and doses of PDE5i, oxygen availability, and exercise characteristics (1,10,15,18,23). On these bases, PDE5i are suggested as therapy to improve exercise capacity in individuals affected by cardiopulmonary diseases, and, from anecdotal reports, they are largely abused by healthy athletes to fraudulently enhance sport performance.…”

mentioning

confidence: 99%

“…The PDE5i (e.g., sildenafil, tadalafil) widely used to treat erectile dysfunction in males have been shown to differently influence exercise capacity and/or energy metabolism during exercise, both in subjects affected by cardiopulmonary diseases and in healthy individuals, depending on the type and doses of PDE5i, oxygen availability, and exercise characteristics (1,10,15,18,23). On these bases, PDE5i are suggested as therapy to improve exercise capacity in individuals affected by cardiopulmonary diseases, and, from anecdotal reports, they are largely abused by healthy athletes to fraudulently enhance sport performance.…”

mentioning

confidence: 99%

The phosphodiesterases type 5 inhibitor tadalafil reduces the activation of the hypothalamus-pituitary-adrenal axis in men during cycle ergometric exercise

Luigi¹,

Sgrò²,

Baldari

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

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The phosphodiesterases type 5 inhibitor tadalafil reduces the activation of the hypothalamus-pituitary-adrenal axis in men during cycle ergometric exercise. Am J Physiol Endocrinol Metab 302: E972-E978, 2012. First published February 7, 2012 doi:10.1152/ajpendo.00573.2011.-Phosphodiesterase type 5 inhibitors may influence human physiology, health, and performance by also modulating endocrine pathways. We evaluated the effects of a 2-day tadalafil administration on adenohypophyseal and adrenal hormone adaptation to exercise in humans. Fourteen healthy males were included in a double-blind crossover trial. Each volunteer randomly received two tablets of placebo or tadalafil (20 mg/day with a 36-h interval) before a maximal exercise was performed. After a 2-wk washout, the volunteers were crossed over. Blood samples were collected at Ϫ30 and Ϫ15 min and immediately before exercise, immediately after, and during recovery (ϩ15, ϩ30, ϩ60, and ϩ90 min) for adrenocorticotropin (ACTH), ␤-endorphin, growth hormone (GH), prolactin, cortisol (C), corticosterone, dehydroepiandrosterone-sulfate (DHEAS), and cortisol binding globulin (CBG) assays. C-to-CBG (free cortisol index, FCI) and DHEAS-to-C ratios were calculated. Exercise intensity, perceived exertion rate, O2 consumption, and CO2 and blood lactate concentration were evaluated. ACTH, GH, C, corticosterone, and CBG absolute concentrations and/or areas under the curve (AUC) increased after exercise after both placebo and tadalafil. Exercise increased DHEAS only after placebo. Compared with placebo, tadalafil administration reduced the ACTH, C, corticosterone, and FCI responses to exercise and was associated with higher ␤-endorphin AUC and DHEAS-to-C ratio during recovery, without influencing cardiorespiratory and performance parameters. Tadalafil reduced the activation of the hypothalamus-pituitary-adrenal axis during exercise by probably influencing the brain's nitric oxide-and cGMP-mediated pathways. Further studies are necessary to confirm our results and to identify the involved mechanisms, possible health risks, and potential clinical uses. nitric oxide; exercise; tadalafil; adrenocorticotropin; cortisol THE SECRETION OF SYSTEMIC stress mediators (e.g., catecholamines, pituitary and adrenal hormones) increases after exercise depending on type, intensity, and duration of performed physical activity, individual characteristics, and associated psychological and metabolic stressors (7,17,21,29,36,48). In addition, many prohibited (e.g., anabolic hormones, glucocorticoids) and nonprohibited [e.g., nonsteroidal anti-inflammatory drugs, phosphodiesterases type 5 (PDE5) inhibitors (PDE5i), amino acids] substances, largely used or abused by athletes, have been shown to influence exercise performances and/or endocrine pathways at rest and during exercise (9 -11, 13, 19, 22).The PDE5i (e.g., sildenafil, tadalafil) widely used to treat erectile dysfunction in males have been shown to differently influence exercise capacity and/or energy metabolism during exercise, both in subj...

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Tadalafil improves quality of life and exercise tolerance in idiopathic pulmonary arterial hypertension

Cited by 36 publications

References 9 publications

Recent Advances in the Treatment of Systemic Sclerosis

Recent Advances in the Treatment of Systemic Sclerosis

Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

The phosphodiesterases type 5 inhibitor tadalafil reduces the activation of the hypothalamus-pituitary-adrenal axis in men during cycle ergometric exercise

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