Document Detail


Effects of sildenafil citrate (Viagra) combined with nitrate on the heart.
MedLine Citation:
PMID:  11076826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sildenafil citrate (Viagra) is indicated for the treatment of erectile dysfunction. Large and sudden decreases in systemic blood pressure were reported in a substantial number of patients taking sildenafil citrate combined with nitroglycerin. We studied the effect of sildenafil citrate on the relationship between changes in systemic blood pressure and coronary blood flow. METHODS AND RESULTS: Healthy male beagles were used to assess systemic blood pressure, pulmonary arterial pressure, and flow in the left circumflex artery (in which a critical stenosis was established) and left anterior descending coronary artery. After measurement of the hemodynamic variables, 2 mg/kg sildenafil citrate was administered via a nasogastric tube. Hemodynamic changes were monitored for 1 hour. Subsequently, the acute effect of nitrate combined with sildenafil citrate was studied by the bolus injection of 0.2 mg isosorbide dinitrate before and after sildenafil citrate. Systemic blood and pulmonary arterial pressures and circumflex flow did not change during this study; however, left anterior descending coronary arterial flow increased from 16.0+/-5.8 to 24.6+/-8.7 mL/min 1 hour after administration of sildenafil citrate. The prolongation of systemic blood pressure decrease and the circumflex flow decrement induced by isosorbide dinitrate after sildenafil citrate were significantly larger and longer than those before sildenafil citrate. CONCLUSIONS: Sildenafil citrate had the effect of vasodilation in a normal coronary artery; however, a combined effect with nitrate resulted in large and protracted decreases in systemic blood pressure and coronary blood flow in vessels with critical stenosis.
Authors:
F Ishikura; S Beppu; T Hamada; B K Khandheria; J B Seward; A Nehra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  102     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-17     Completed Date:  2000-12-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2516-21     Citation Subset:  IM    
Affiliation:
School of Allied Health Sciences, Osaka University, Faculty of Medicine, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Animals
Blood Flow Velocity / drug effects
Blood Pressure / drug effects*
Cardiac Output / drug effects
Coronary Artery Bypass
Coronary Circulation / drug effects*
Coronary Disease / drug therapy
Coronary Vessels / drug effects,  surgery
Dogs
Drug Synergism
Heart / drug effects*
Heart Rate / drug effects
Injections
Isosorbide Dinitrate / administration & dosage*
Male
Phosphodiesterase Inhibitors / pharmacology
Piperazines / administration & dosage*,  blood
Pulmonary Artery / drug effects,  physiology
Purines
Stroke Volume / drug effects
Sulfones
Vasodilator Agents / pharmacology
Chemical
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 139755-83-2/sildenafil; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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