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The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review

Agents that augment cerebral blood flow (CBF) could be potential treatments for vascular cognitive impairment. Phosphodiesterase-5 inhibitors are vasodilating drugs established in the treatment of erectile dysfunction (ED) and pulmonary hypertension. We reviewed published data on the effects of phos...

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Autores principales: Pauls, Mathilde MH, Moynihan, Barry, Barrick, Thomas R, Kruuse, Christina, Madigan, Jeremy B, Hainsworth, Atticus H, Isaacs, Jeremy D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5951021/
https://www.ncbi.nlm.nih.gov/pubmed/29256324
http://dx.doi.org/10.1177/0271678X17747177
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author Pauls, Mathilde MH
Moynihan, Barry
Barrick, Thomas R
Kruuse, Christina
Madigan, Jeremy B
Hainsworth, Atticus H
Isaacs, Jeremy D
author_facet Pauls, Mathilde MH
Moynihan, Barry
Barrick, Thomas R
Kruuse, Christina
Madigan, Jeremy B
Hainsworth, Atticus H
Isaacs, Jeremy D
author_sort Pauls, Mathilde MH
collection PubMed
description Agents that augment cerebral blood flow (CBF) could be potential treatments for vascular cognitive impairment. Phosphodiesterase-5 inhibitors are vasodilating drugs established in the treatment of erectile dysfunction (ED) and pulmonary hypertension. We reviewed published data on the effects of phosphodiesterase-5 inhibitors on CBF in adult humans. A systematic review according to PRISMA guidelines was performed. Embase, Medline and Cochrane Library Trials databases were searched. Sixteen studies with 353 participants in total were retrieved. Studies included healthy volunteers and patients with migraine, ED, type 2 diabetes, stroke, pulmonary hypertension, Becker muscular dystrophy and subarachnoid haemorrhage. Most studies used middle cerebral artery flow velocity to estimate CBF. Few studies employed direct measurements of tissue perfusion. Resting CBF velocity was unaffected by phosphodiesterase-5 inhibitors, but cerebrovascular regulation was improved in ED, pulmonary hypertension, diabetes, Becker's and a group of healthy volunteers. This evidence suggests that phosphodiesterase-5 inhibitors improve responsiveness of the cerebral vasculature, particularly in disease states associated with an impaired endothelial dilatory response. This supports the potential therapeutic use of phosphodiesterase-5 inhibitors in vascular cognitive impairment where CBF is reduced. Further studies with better resolution of deep CBF are warranted. The review is registered on the PROSPERO database (registration number CRD42016029668).
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spelling pubmed-59510212019-02-01 The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review Pauls, Mathilde MH Moynihan, Barry Barrick, Thomas R Kruuse, Christina Madigan, Jeremy B Hainsworth, Atticus H Isaacs, Jeremy D J Cereb Blood Flow Metab Review Articles Agents that augment cerebral blood flow (CBF) could be potential treatments for vascular cognitive impairment. Phosphodiesterase-5 inhibitors are vasodilating drugs established in the treatment of erectile dysfunction (ED) and pulmonary hypertension. We reviewed published data on the effects of phosphodiesterase-5 inhibitors on CBF in adult humans. A systematic review according to PRISMA guidelines was performed. Embase, Medline and Cochrane Library Trials databases were searched. Sixteen studies with 353 participants in total were retrieved. Studies included healthy volunteers and patients with migraine, ED, type 2 diabetes, stroke, pulmonary hypertension, Becker muscular dystrophy and subarachnoid haemorrhage. Most studies used middle cerebral artery flow velocity to estimate CBF. Few studies employed direct measurements of tissue perfusion. Resting CBF velocity was unaffected by phosphodiesterase-5 inhibitors, but cerebrovascular regulation was improved in ED, pulmonary hypertension, diabetes, Becker's and a group of healthy volunteers. This evidence suggests that phosphodiesterase-5 inhibitors improve responsiveness of the cerebral vasculature, particularly in disease states associated with an impaired endothelial dilatory response. This supports the potential therapeutic use of phosphodiesterase-5 inhibitors in vascular cognitive impairment where CBF is reduced. Further studies with better resolution of deep CBF are warranted. The review is registered on the PROSPERO database (registration number CRD42016029668). SAGE Publications 2017-12-19 2018-02 /pmc/articles/PMC5951021/ /pubmed/29256324 http://dx.doi.org/10.1177/0271678X17747177 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Pauls, Mathilde MH
Moynihan, Barry
Barrick, Thomas R
Kruuse, Christina
Madigan, Jeremy B
Hainsworth, Atticus H
Isaacs, Jeremy D
The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review
title The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review
title_full The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review
title_fullStr The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review
title_full_unstemmed The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review
title_short The effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: A systematic review
title_sort effect of phosphodiesterase-5 inhibitors on cerebral blood flow in humans: a systematic review
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5951021/
https://www.ncbi.nlm.nih.gov/pubmed/29256324
http://dx.doi.org/10.1177/0271678X17747177
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