Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1152/ajpregu.00183.2014 http://repositorio.unifesp.br/handle/11600/38094 |
Resumo: | Endothelial dysfunction caused by defective nitric oxide (NO) signaling plays a pivotal role in the pathogenesis of intermittent claudication (IC). in the present study, we evaluated the acute effects of sildenafil, a phosphodiesterase type 5 inhibitor that acts by prolonging NO-mediated cGMP signaling in vascular smooth muscle, on blood pressure (BP), skeletal muscle oxygenation, and walking tolerance in patients with IC. A randomized, double-blind, crossover study was conducted in which 12 men with stable IC received two consecutive doses of 50 mg of sildenafil or matching placebo and underwent a symptom-limited exercise test on the treadmill. Changes in gastrocnemius deoxy-hemoglobin by near-infrared spectroscopy estimated peripheral muscle O-2 delivery-to-utilization matching. Systolic BP was significantly lower during the sildenafil trial relative to placebo during supine rest (similar to 15 mmHg), submaximal exercise (similar to 14 mmHg), and throughout recovery (similar to 18 mmHg) (P < 0.05). Diastolic BP was also lower after sildenafil during upright rest (similar to 6 mmHg) and during recovery from exercise (similar to 7 mmHg) (P < 0.05). Gastrocnemius deoxygenation was consistently reduced during submaximal exercise (similar to 41%) and at peak exercise (similar to 34%) following sildenafil compared with placebo (P < 0.05). However, pain-free walking time (placebo: 335 +/- 42 s vs. sildenafil: 294 +/- 35 s) and maximal walking time (placebo: 701 +/- 58 s vs. sildenafil: 716 +/- 62 s) did not differ between trials. Acute administration of sildenafil lowers BP and improves skeletal muscle oxygenation during exercise but does not enhance walking tolerance in patients with IC. Whether the beneficial effects of sildenafil on muscle oxygenation can be sustained over time and translated into positive clinical outcomes deserve further consideration in this patient population. |
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Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudicationintermittent claudicationsildenafilblood flowexerciseEndothelial dysfunction caused by defective nitric oxide (NO) signaling plays a pivotal role in the pathogenesis of intermittent claudication (IC). in the present study, we evaluated the acute effects of sildenafil, a phosphodiesterase type 5 inhibitor that acts by prolonging NO-mediated cGMP signaling in vascular smooth muscle, on blood pressure (BP), skeletal muscle oxygenation, and walking tolerance in patients with IC. A randomized, double-blind, crossover study was conducted in which 12 men with stable IC received two consecutive doses of 50 mg of sildenafil or matching placebo and underwent a symptom-limited exercise test on the treadmill. Changes in gastrocnemius deoxy-hemoglobin by near-infrared spectroscopy estimated peripheral muscle O-2 delivery-to-utilization matching. Systolic BP was significantly lower during the sildenafil trial relative to placebo during supine rest (similar to 15 mmHg), submaximal exercise (similar to 14 mmHg), and throughout recovery (similar to 18 mmHg) (P < 0.05). Diastolic BP was also lower after sildenafil during upright rest (similar to 6 mmHg) and during recovery from exercise (similar to 7 mmHg) (P < 0.05). Gastrocnemius deoxygenation was consistently reduced during submaximal exercise (similar to 41%) and at peak exercise (similar to 34%) following sildenafil compared with placebo (P < 0.05). However, pain-free walking time (placebo: 335 +/- 42 s vs. sildenafil: 294 +/- 35 s) and maximal walking time (placebo: 701 +/- 58 s vs. sildenafil: 716 +/- 62 s) did not differ between trials. Acute administration of sildenafil lowers BP and improves skeletal muscle oxygenation during exercise but does not enhance walking tolerance in patients with IC. Whether the beneficial effects of sildenafil on muscle oxygenation can be sustained over time and translated into positive clinical outcomes deserve further consideration in this patient population.Universidade Federal de São Paulo, Pulm Funct & Clin Exercise Physiol Unit, Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilUniv São Paulo, Div Vasc Surg, Dept Surg, São Paulo, BrazilQueens Univ, Kingston, ON, CanadaKingston Gen Hosp, Lab Clin Exercise Physiol, Dept Med, Kingston, ON K7L 2V7, CanadaUniversidade Federal de São Paulo, Pulm Funct & Clin Exercise Physiol Unit, Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilWeb of ScienceAmer Physiological SocUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)Queens UnivKingston Gen HospRoseguini, Bruno T. [UNIFESP]Hirai, Daniel M. [UNIFESP]Alencar, Maria C. [UNIFESP]Ramos, Roberta P. [UNIFESP]Silva, Bruno M. [UNIFESP]Wolosker, NelsonNeder, J. Alberto [UNIFESP]Nery, Luiz E. [UNIFESP]2016-01-24T14:37:44Z2016-01-24T14:37:44Z2014-08-15info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionR396-R404http://dx.doi.org/10.1152/ajpregu.00183.2014American Journal of Physiology-regulatory Integrative and Comparative Physiology. Bethesda: Amer Physiological Soc, v. 307, n. 4, p. R396-R404, 2014.10.1152/ajpregu.00183.20140363-6119http://repositorio.unifesp.br/handle/11600/38094WOS:000340834700005engAmerican Journal of Physiology-regulatory Integrative and Comparative Physiologyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2016-01-24T12:37:44Zoai:repositorio.unifesp.br/:11600/38094Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652016-01-24T12:37:44Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
title |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
spellingShingle |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication Roseguini, Bruno T. [UNIFESP] intermittent claudication sildenafil blood flow exercise |
title_short |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
title_full |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
title_fullStr |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
title_full_unstemmed |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
title_sort |
Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication |
author |
Roseguini, Bruno T. [UNIFESP] |
author_facet |
Roseguini, Bruno T. [UNIFESP] Hirai, Daniel M. [UNIFESP] Alencar, Maria C. [UNIFESP] Ramos, Roberta P. [UNIFESP] Silva, Bruno M. [UNIFESP] Wolosker, Nelson Neder, J. Alberto [UNIFESP] Nery, Luiz E. [UNIFESP] |
author_role |
author |
author2 |
Hirai, Daniel M. [UNIFESP] Alencar, Maria C. [UNIFESP] Ramos, Roberta P. [UNIFESP] Silva, Bruno M. [UNIFESP] Wolosker, Nelson Neder, J. Alberto [UNIFESP] Nery, Luiz E. [UNIFESP] |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Universidade de São Paulo (USP) Queens Univ Kingston Gen Hosp |
dc.contributor.author.fl_str_mv |
Roseguini, Bruno T. [UNIFESP] Hirai, Daniel M. [UNIFESP] Alencar, Maria C. [UNIFESP] Ramos, Roberta P. [UNIFESP] Silva, Bruno M. [UNIFESP] Wolosker, Nelson Neder, J. Alberto [UNIFESP] Nery, Luiz E. [UNIFESP] |
dc.subject.por.fl_str_mv |
intermittent claudication sildenafil blood flow exercise |
topic |
intermittent claudication sildenafil blood flow exercise |
description |
Endothelial dysfunction caused by defective nitric oxide (NO) signaling plays a pivotal role in the pathogenesis of intermittent claudication (IC). in the present study, we evaluated the acute effects of sildenafil, a phosphodiesterase type 5 inhibitor that acts by prolonging NO-mediated cGMP signaling in vascular smooth muscle, on blood pressure (BP), skeletal muscle oxygenation, and walking tolerance in patients with IC. A randomized, double-blind, crossover study was conducted in which 12 men with stable IC received two consecutive doses of 50 mg of sildenafil or matching placebo and underwent a symptom-limited exercise test on the treadmill. Changes in gastrocnemius deoxy-hemoglobin by near-infrared spectroscopy estimated peripheral muscle O-2 delivery-to-utilization matching. Systolic BP was significantly lower during the sildenafil trial relative to placebo during supine rest (similar to 15 mmHg), submaximal exercise (similar to 14 mmHg), and throughout recovery (similar to 18 mmHg) (P < 0.05). Diastolic BP was also lower after sildenafil during upright rest (similar to 6 mmHg) and during recovery from exercise (similar to 7 mmHg) (P < 0.05). Gastrocnemius deoxygenation was consistently reduced during submaximal exercise (similar to 41%) and at peak exercise (similar to 34%) following sildenafil compared with placebo (P < 0.05). However, pain-free walking time (placebo: 335 +/- 42 s vs. sildenafil: 294 +/- 35 s) and maximal walking time (placebo: 701 +/- 58 s vs. sildenafil: 716 +/- 62 s) did not differ between trials. Acute administration of sildenafil lowers BP and improves skeletal muscle oxygenation during exercise but does not enhance walking tolerance in patients with IC. Whether the beneficial effects of sildenafil on muscle oxygenation can be sustained over time and translated into positive clinical outcomes deserve further consideration in this patient population. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-08-15 2016-01-24T14:37:44Z 2016-01-24T14:37:44Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1152/ajpregu.00183.2014 American Journal of Physiology-regulatory Integrative and Comparative Physiology. Bethesda: Amer Physiological Soc, v. 307, n. 4, p. R396-R404, 2014. 10.1152/ajpregu.00183.2014 0363-6119 http://repositorio.unifesp.br/handle/11600/38094 WOS:000340834700005 |
url |
http://dx.doi.org/10.1152/ajpregu.00183.2014 http://repositorio.unifesp.br/handle/11600/38094 |
identifier_str_mv |
American Journal of Physiology-regulatory Integrative and Comparative Physiology. Bethesda: Amer Physiological Soc, v. 307, n. 4, p. R396-R404, 2014. 10.1152/ajpregu.00183.2014 0363-6119 WOS:000340834700005 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
American Journal of Physiology-regulatory Integrative and Comparative Physiology |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
R396-R404 |
dc.publisher.none.fl_str_mv |
Amer Physiological Soc |
publisher.none.fl_str_mv |
Amer Physiological Soc |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268381499490304 |