Chronic inhibition of cGMP phosphodiesterase 5A improves diabetic cardiomyopathy: A randomized, controlled clinical trial using magnetic resonance imaging with myocardial tagging

Elisa Giannetta, Andrea M. Isidori, Nicola Galea, Iacopo Carbone, Elisabetta Mandosi, Carmine D. Vizza, Fabio Naro, Susanna Morano, Francesco Fedele, Andrea Lenzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background-cGMP phosphodiesterase type 5 protein is upregulated in myocardial hypertrophy. However, it has never been ascertained whether phosphodiesterase type 5 inhibition exerts an antiremodeling effect in nonischemic heart disease in humans. We explored the cardioreparative properties of a selective phosphodiesterase type 5 inhibitor, sildenafil, in a model of diabetic cardiomyopathy. Methods and Results-Fifty-nine diabetic men (60.3±7.4 years) with cardiac magnetic resonance imaging consistent with nonischemic, nonfailing diabetic cardiomyopathy (reduced circumferential strain [σ],-12.6±3.1; increased left ventricular [LV] torsion [θ], 18.4±4.6°; and increased ratio of LV mass to volume, 2.1±0.5 g/mL) were randomized to receive sildenafil or placebo (100 mg/d). At baseline, the metabolic indices were correlated with torsion, strain, N-terminal pro-B-type natriuretic peptide, vascular endothelial growth factor, monocyte chemotactic protein-1, and blood pressure. After 3 months, sildenafil produced a significant improvement compared with placebo in LV torsion (Δθ: sildenafil,-3.89±3.11° versus placebo, 2.13±2.35°; P

Original languageEnglish
Pages (from-to)2323-2333
Number of pages11
JournalCirculation
Volume125
Issue number19
DOIs
Publication statusPublished - May 15 2012

Keywords

  • cardiac magnetic resonance imaging
  • diabetes mellitus type 2
  • diabetic diastolic heart failure
  • fibrosis
  • phosphodiesterase inhibitors heart failure

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

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