Fung Erik, Fiscus Ronald R, Yim Anthony P C, Angelini Gianni D, Arifi Ahmed A
Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
Chest. 2005 Oct;128(4):3065-73. doi: 10.1378/chest.128.4.3065.
Exaggerated vasospasm, platelet activation, and early graft occlusion are significant barriers to successful coronary artery bypass grafting (CABG). Interestingly, vascular smooth muscle and platelets are predominant sources of type-5 phosphodiesterase (PDE5) in the body, and this enzyme is specifically inhibited by PDE5 inhibitors (eg, sildenafil citrate). Together with endogenous nitric oxide, sildenafil can induce pulmonary and coronary vasodilation, precondition the myocardium, reduce platelet activation, and potentially reduce early graft occlusion. Currently, there are no published clinical trials investigating sildenafil in coronary surgery. Recent studies on the potential use of sildenafil strongly support its beneficial effects in a wide range of patients with cardiovascular diseases. Therefore, we sought to review the literature, explore the current hypothesis that the use of sildenafil in coronary surgery patients can be beneficial, and attempt to define its potential place in the setting of CABG.
过度血管痉挛、血小板激活和早期移植物闭塞是冠状动脉旁路移植术（CABG）成功的重大障碍。有趣的是，血管平滑肌和血小板是体内5型磷酸二酯酶（PDE5）的主要来源，而该酶可被PDE5抑制剂（如枸橼酸西地那非）特异性抑制。西地那非与内源性一氧化氮一起，可诱导肺血管和冠状动脉扩张，对心肌进行预处理，减少血小板激活，并可能减少早期移植物闭塞。目前，尚无关于西地那非在冠状动脉手术中的临床试验发表。最近关于西地那非潜在用途的研究有力地支持了其在广泛心血管疾病患者中的有益作用。因此，我们试图回顾文献，探讨目前关于在冠状动脉手术患者中使用西地那非有益的假说，并尝试确定其在CABG中的潜在地位。
