Cardiovascular Diseases and Sexual Health Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
J Clin Pharmacol. 2012 Aug;52(8):1215-21. doi: 10.1177/0091270011413586. Epub 2011 Sep 27.
Although vardenafil is widely prescribed for erectile dysfunction (ED), its effect on arterial function is not defined. Aortic stiffness, aortic pressures, and wave reflections are predictors of cardiovascular risk. The investigators assessed the hypothesis that vardenafil acutely improves aortic stiffness, aortic pressures, and wave reflections in ED patients. Twelve ED patients (mean age 58 ± 9 years) received vardenafil 20 mg in a randomized, placebo-controlled, double-blind, 2-way crossover design. Aortic stiffness was evaluated with carotid-femoral pulse wave velocity (PWV); wave reflections and aortic pressures were evaluated with augmentation index (AIx) and systolic, diastolic, and pulse pressure of the aortic pressure waveform, respectively. PWV, aortic pressures, and AIx were measured at baseline and for 3 hours after vardenafil intake or placebo. PWV decreased significantly (by 0.7 m/s, P = .001), denoting a decrease in aortic stiffness. AIx decreased significantly (by 7%, P = .008), denoting a decreased effect of wave reflections from the periphery. Aortic pressures decreased significantly (all P < .05). Statin use at baseline significantly interacted with the effects of treatment on both PWV and AIx (P = .003 and P < .001, respectively). This study shows, for the first time, that vardenafil has a favorable acute effect on aortic stiffness and wave reflection in ED patients.
尽管伐地那非被广泛用于治疗勃起功能障碍（ED），但其对动脉功能的影响尚未明确。主动脉僵硬度、主动脉压力和波反射是心血管风险的预测因素。研究人员评估了这样一个假设，即伐地那非可在 ED 患者中急性改善主动脉僵硬度、主动脉压力和波反射。12 名 ED 患者（平均年龄 58±9 岁）接受了伐地那非 20mg 的随机、安慰剂对照、双盲、2 向交叉设计。通过颈股脉搏波速度（PWV）评估主动脉僵硬度；通过增强指数（AIx）和主动脉压力波形的收缩压、舒张压和脉压评估波反射和主动脉压力。在基线时和伐地那非摄入或安慰剂后 3 小时测量 PWV、主动脉压力和 AIx。PWV 显著降低（降低 0.7m/s，P=0.001），表明主动脉僵硬度降低。AIx 显著降低（降低 7%，P=0.008），表明外周波反射的影响降低。主动脉压力显著降低（均 P<0.05）。基线时使用他汀类药物与治疗对 PWV 和 AIx 的影响显著相互作用（P=0.003 和 P<0.001）。本研究首次表明，伐地那非对 ED 患者的主动脉僵硬度和波反射具有有利的急性作用。
