The current review explores the biochemical mechanisms involved in the cardioprotection of PDE5 inhibitors. In addition, clinical trials investigating PDE5 inhibition in patients with coronary artery disease, heart failure, and ventricular arrhythmias have been reviewed. Heart disease and erectile dysfunction commonly occur together, possibly due to endothelial dysfunction in both diseases. There are millions of patients with cardiovascular disease who receive treatments for erectile dysfunction with phosphodiesterase-5 (PDE5) inhibitors. The benefits of PDE5 inhibitors for treating erectile dysfunction are well established, but their effect on the cardiovascular system is unclear. PDE5 inhibitors may have a clinical role in pressure overload-induced hypertrophy, ischemia-reperfusion injury, and chemotoxicity, according to preclinical studies.
There have been mixed results when these findings have been implemented at the bedside.