title: Role of phosphodiesterase-5 inhibitors in heart failure: emerging data and concepts.
abstract: Novel treatment of congestive heart failure (HF) involves utilizing unique pathways to improve upon contemporary therapies. Increasing the availability of cyclic guanosine monophosphate (cGMP) by inhibition of phosphodiesterase-5 (PDE5) is a relatively new, but promising therapeutic strategy. Preclinical studies suggest a favorable myocardial effect of PDE5 inhibitors by blocking adrenergic, hypertrophic and pro-apoptotic signaling, thereby supporting their use in HF. The clinical benefits of acute and chronic PDE5 inhibition on lung diffusion capacity, exercise performance and ejection fraction in humans are emerging and appear promising. Larger, controlled trials are now on-going to assess the safety, efficacy and tolerability of PDE5 inhibitors on morbidity and mortality in patients with both systolic and diastolic heart failure. If the results of these trials are positive, a new avenue for the treatment of HF will open, which will help curtail the societal effects of this costly and morbid disease.
authors.affiliation: Department of Medicine, Division of Cardiovascular Diseases, The Cardiovascular Institute at Allegheny General Hospital, 320 East North Ave, Pittsburgh, PA 15212, USA.
authors.forename: Manreet
authors.initials: M
authors.lastname: Kanwar
authors.forename: Richa
authors.initials: R
authors.lastname: Agarwal
authors.forename: Megan
authors.initials: M
authors.lastname: Barnes
authors.forename: James
authors.initials: J
authors.lastname: Coons
authors.forename: Amresh
authors.initials: A
authors.lastname: Raina
authors.forename: George
authors.initials: G
authors.lastname: Sokos
authors.forename: Srinivas
authors.initials: S
authors.lastname: Murali
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Benza
mesh_terms: D006152:Cyclic GMP / Q000502:physiology; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D009569:Nitric Oxide / Q000502:physiology; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D015398:Signal Transduction / Q000502:physiology
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D009569:Nitric Oxide; D006152:Cyclic GMP