Pharmacological postconditioning by bolus injection of phosphodiesterase-5 inhibitors vardenafil and sildenafil

Mol Cell Biochem. 2013 Jul;379(1-2):43-9. doi: 10.1007/s11010-013-1625-7. Epub 2013 Mar 27.

Abstract

Postconditioning enables cardioprotection against ischemia/reperfusion injury either by application of short, repetitive ischemic periods or by pharmacological intervention prior to reperfusion. Pharmacological postconditioning has been described for phosphodiesterase-5 inhibitors when the substances were applied as a permanent infusion. For clinical purposes, application of a bolus is more convenient. In a rat heart in situ model of ischemia reperfusion vardenafil or sildenafil were applied as a bolus prior to reperfusion. Cardioprotective effects were found over a broad dosage range. In accordance with current hypotheses on pharmacological postconditioning signaling, the protective effect was mediated by extracellular signal-regulated kinase and protein kinase C pathway. Interestingly, the extent of protection was independent of the concentration applied for both substances. Full protection comparable to ischemic postconditioning was reached with half-maximal human equivalence dose. In contrast, mean arterial pressure dropped upon bolus application in a dose-dependent manner. Taken together, the current study extends previous findings obtained in a permanent infusion model to bolus application. This is an important step toward clinical application of pharmacological postconditioning with sildenafil and vardenafil, especially because the beneficial effects were proven for concentrations with reduced hemodynamic side effects compared to the dosage applied for erectile dysfunction treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cardiotonic Agents / administration & dosage*
  • Cardiotonic Agents / pharmacology
  • Cyclic GMP / metabolism
  • Extracellular Signal-Regulated MAP Kinases / antagonists & inhibitors
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Flavonoids / pharmacology
  • Imidazoles / administration & dosage*
  • Imidazoles / pharmacology
  • Male
  • Myocardial Infarction / complications
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / pathology
  • Myocardial Reperfusion Injury / etiology
  • Myocardial Reperfusion Injury / pathology
  • Myocardial Reperfusion Injury / prevention & control*
  • Myocardium / enzymology
  • Myocardium / pathology
  • Phosphodiesterase 5 Inhibitors / administration & dosage*
  • Phosphodiesterase 5 Inhibitors / pharmacology
  • Piperazines / administration & dosage*
  • Piperazines / pharmacology
  • Protein Kinase C / metabolism
  • Purines / administration & dosage
  • Purines / pharmacology
  • Rats
  • Rats, Wistar
  • Sildenafil Citrate
  • Sulfones / administration & dosage*
  • Sulfones / pharmacology
  • Triazines / administration & dosage
  • Triazines / pharmacology
  • Vardenafil Dihydrochloride

Substances

  • Cardiotonic Agents
  • Flavonoids
  • Imidazoles
  • Phosphodiesterase 5 Inhibitors
  • Piperazines
  • Purines
  • Sulfones
  • Triazines
  • Vardenafil Dihydrochloride
  • Sildenafil Citrate
  • Protein Kinase C
  • Extracellular Signal-Regulated MAP Kinases
  • Cyclic GMP
  • 2-(2-amino-3-methoxyphenyl)-4H-1-benzopyran-4-one