New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy
Inhibitors of phosphodiesterase type 5 (PDE5i) are the first-line treatment for erectile dysfunction and are also used to treat pulmonary hypertension. PDE5i impedes the breakdown of nitric oxide (NO)-driven cyclic guanosine monophosphate (cGMP) in smooth muscle cells of the vascular bed, acting as...
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| Format: | Article |
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MDPI AG
2022-06-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/12/11/5629 |
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| author | Felice Crocetto Vittoria Cuomo Ciro Santoro Ludovica Fiorillo Biagio Barone Davide Arcaniolo Teresa Fedele Ciro Imbimbo Roberta Esposito |
| author_facet | Felice Crocetto Vittoria Cuomo Ciro Santoro Ludovica Fiorillo Biagio Barone Davide Arcaniolo Teresa Fedele Ciro Imbimbo Roberta Esposito |
| author_sort | Felice Crocetto |
| collection | DOAJ |
| description | Inhibitors of phosphodiesterase type 5 (PDE5i) are the first-line treatment for erectile dysfunction and are also used to treat pulmonary hypertension. PDE5i impedes the breakdown of nitric oxide (NO)-driven cyclic guanosine monophosphate (cGMP) in smooth muscle cells of the vascular bed, acting as a potent vasodilator. In heart failure, cGMP signaling is altered. The modulation of cGMP has therefore emerged as a potential therapeutic option for heart failure. In this prospective observational study, we aim to investigate whether tadalafil, a long-acting PDE5i used for erectile dysfunction, could also improve diastolic function assessed by cardiac ultrasound. A total of 23 patients were enrolled, undergoing nerve-sparing robot-assisted radical prostatectomy for prostate cancer and treated with 20 mg tadalafil on alternate days to recover erectile function. All patients underwent tadalafil treatment for at least 6 months. Participants underwent a clinical and cardiac ultrasound with color Doppler assessment at baseline, after 3 months, and after 6 months. At 6 months, no significant difference was found apart from lower E/e’ ratio (7.4 ± 2.7 vs. 6.3 ± 1.3; <i>p</i> < 0.03), peak velocity of TR jet (2.4 ± 0.2 vs. 2.1 ± 0.2; <i>p</i> < 0.001), and PAPs (27.3 ± 3.6 vs. 22.9 ± 5.7; <i>p</i> < 0.005). Our prospective study shows that 6 months of erectile dysfunction therapy for secondary to radical prostatectomy is associated with a favorable effect on diastolic function, improving the E/e’ ratio and peak velocity of the TR jet. |
| first_indexed | 2024-03-10T01:30:10Z |
| format | Article |
| id | doaj.art-de8a833d5d7b469e804434b407ee410d |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T01:30:10Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-de8a833d5d7b469e804434b407ee410d2023-11-23T13:45:05ZengMDPI AGApplied Sciences2076-34172022-06-011211562910.3390/app12115629New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical ProstatectomyFelice Crocetto0Vittoria Cuomo1Ciro Santoro2Ludovica Fiorillo3Biagio Barone4Davide Arcaniolo5Teresa Fedele6Ciro Imbimbo7Roberta Esposito8Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University Hospital, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, Federico II University Hospital, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University Hospital, 80131 Naples, ItalyUrology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University Hospital, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, ItalyInhibitors of phosphodiesterase type 5 (PDE5i) are the first-line treatment for erectile dysfunction and are also used to treat pulmonary hypertension. PDE5i impedes the breakdown of nitric oxide (NO)-driven cyclic guanosine monophosphate (cGMP) in smooth muscle cells of the vascular bed, acting as a potent vasodilator. In heart failure, cGMP signaling is altered. The modulation of cGMP has therefore emerged as a potential therapeutic option for heart failure. In this prospective observational study, we aim to investigate whether tadalafil, a long-acting PDE5i used for erectile dysfunction, could also improve diastolic function assessed by cardiac ultrasound. A total of 23 patients were enrolled, undergoing nerve-sparing robot-assisted radical prostatectomy for prostate cancer and treated with 20 mg tadalafil on alternate days to recover erectile function. All patients underwent tadalafil treatment for at least 6 months. Participants underwent a clinical and cardiac ultrasound with color Doppler assessment at baseline, after 3 months, and after 6 months. At 6 months, no significant difference was found apart from lower E/e’ ratio (7.4 ± 2.7 vs. 6.3 ± 1.3; <i>p</i> < 0.03), peak velocity of TR jet (2.4 ± 0.2 vs. 2.1 ± 0.2; <i>p</i> < 0.001), and PAPs (27.3 ± 3.6 vs. 22.9 ± 5.7; <i>p</i> < 0.005). Our prospective study shows that 6 months of erectile dysfunction therapy for secondary to radical prostatectomy is associated with a favorable effect on diastolic function, improving the E/e’ ratio and peak velocity of the TR jet.https://www.mdpi.com/2076-3417/12/11/5629diastolic disfunctionechocardiographyerectile dysfunctionnitric oxide signaling |
| spellingShingle | Felice Crocetto Vittoria Cuomo Ciro Santoro Ludovica Fiorillo Biagio Barone Davide Arcaniolo Teresa Fedele Ciro Imbimbo Roberta Esposito New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy Applied Sciences diastolic disfunction echocardiography erectile dysfunction nitric oxide signaling |
| title | New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy |
| title_full | New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy |
| title_fullStr | New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy |
| title_full_unstemmed | New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy |
| title_short | New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy |
| title_sort | new possibilities in heart failure the effects of tadalafil on diastolic function in patients undergoing robot assisted radical prostatectomy |
| topic | diastolic disfunction echocardiography erectile dysfunction nitric oxide signaling |
| url | https://www.mdpi.com/2076-3417/12/11/5629 |
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