Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.4.1 (phosphodiesterase)
 18,767 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A significant proportion of myocardial ischemia is 'silent' in nature. Furthermore, this asymptomatic ischemia portends an adverse prognosis for patients with known coronary artery disease. Silent myocardial ischemia can be objectively assessed and quantified by a number of noninvasive means; however, ambulatory electrocardiographic monitoring has emerged as a preferred method for both detection and analysis in hospital and during daily life conditions. Silent myocardial ischemia exhibits a circadian pattern. It represents an imbalance between myocardial oxygen supply and myocardial oxygen demand, and can be triggered by both physical and mental stress. The important role of endothelial dysfunction and autonomic nervous system influences has been recently elucidated. Up to 75% of ischemic episodes in patients are silent. Patients with asymptomatic coronary artery disease, chronic stable angina and unstable angina, and those postmyocardial infarction or postrevascularization who exhibit ST segment shift all show adverse short and long term prognosis compared with controls. Treatment modalities have included nitrates, beta-blockers, calcium antagonists, phosphodiesterase inhibitors, anxiolytics, anti-platelet agents and revascularization procedures. While the majority of these studies have demonstrated significant reduction in the frequency of silent myocardial ischemia, limited data on influencing prognosis are available; thus recommendations regarding treatment of these patients await the results of ongoing clinical trials.
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PMID:Current status of silent myocardial ischemia. 772 40

Clinical evidence in men with erectile dysfunction (ED) shows that the phosphodiesterase type 5 (PDE5) inhibitors sildenafil citrate, tadalafil, and vardenafil hydrochloride have favorable safety and efficacy profiles. However, as mild vasodilators, the PDE5 inhibitors are also associated with hemodynamic effects that may be clinically significant, especially when treating men with ED who have comorbid cardiovascular disease. Hemodynamic studies have shown that therapeutic dosages of the PDE5 inhibitors produce only mild and transient changes in mean systolic and diastolic blood pressure and heart rate in healthy men as well as those with ischemic heart disease or chronic stable angina. Overall, PDE5 inhibitors are safe and effective in most patient populations, including men with ischemic cardiovascular disease or those receiving anti-hypertensive agents, and men with diabetes or those who have undergone nerve-sparing retropubic radical prostatectomy. With the entry of three novel PDE5 inhibitors into the therapeutic armamentarium for ED, differentiating properties of the new agents may confer clinical benefits that physicians as well as patients and their partners should consider when selecting a PDE5 inhibitor.
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PMID:Pharmacokinetics, pharmacodynamics, and efficacy of phosphodiesterase type 5 inhibitors. 1508 94