title: Autonomic cerebral vascular response to sildenafil in diabetic patient.
abstract: BACKGROUND
  Erectile dysfunction is a common problem in type 2 diabetic patients who are at higher risk of cerebrovascular events, and it's recorded with sildenafil, a drug which is primarily used for erectile dysfunction.
  
  
  OBJECTIVE
  We tested the hypothesis whether or not sildenafil modulates cerebrovascular reactivity (CVR) in patients with type 2 diabetes mellitus.
  
  
  METHODS
  A total of 35 male participants were enrolled; eighteen with type 2 diabetes mellitus matched with seventeen normal individuals. Transcranial Doppler Ultrasonographic examination (TCD) was performed for all participants to insonate the middle cerebral artery (MCA) through a trans-temporal window. CVR was assessed by using breath holding (BH)-hyperventilation (HV) test, before and after oral 50 mg sildenafil; recordings were analyzed by using SPSS program version 12.
  
  
  RESULTS
  In normal individuals, sildenafil did not result in statistically significant change in breath holding index (BHI) from 0.91 ± 0.11 to 0.81 ± 0.09 and full range of vasodilatation (FVD) from (59.4% ± 6.3%) to (53.7% ± 4.9%). In diabetic patients, giving sildenafil resulted in significant increase in BHI (from 0.74 ± 0.14 to 1.03 ± 0.14) and FVD (from 60.2% ± 4.96% to 74% ± 4.8%), (p < 0.05).
  
  
  CONCLUSIONS
  Sildenafil significantly improves CVR in type 2 diabetic patients but not in normal subjects.
authors.affiliation: FRCS, FACS, Department of Surgery, postal code 474, Medical college Kufa University, Kufa Najaf street, Najaf, Iraq. fadhil.al-amran@ucdenver.edu.
authors.forename: Fadhil G
authors.initials: FG
authors.lastname: Al-Amran
authors.forename: Akeel Amh
authors.initials: AA
authors.lastname: Zwain
authors.forename: Najah R
authors.initials: NR
authors.lastname: Hadi
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Al-Mudhaffer