P.029 Long-Term Sildenafil Administration Improves Aortic Elastic Properties and Wave Reflections in Patients with Erectile Dysfunction of Vascular Origin

Abstract

Background

Aortic stiffness and wave reflections are independent prognosticators of cardiovascular risk and may be impaired in men with erectile dysfunction (ED) considered as the first clinical manifestation of a generalized vascular disease. We investigated the chronic effect of a long-term daily sildenafil administration on aortic elastic properties and wave reflections.

Methods

The chronic effect of a 2-week long treatment with sildenafil on aortic stiffness and wave reflections were studied in 11 men (age 58±15 years) with non-hormonal and non-psychogenic ED. The study was carried out on two separate arms, one with sildenafil (100 mg) and one with placebo according to a randomized, placebo-controlled, double-blind, cross over design. All measurements were performed 24 hours after the last sildenafil or placebo intake. Aortic stiffness was evaluated with carotid-femoral pulse wave velocity (PWV) and wave reflections with augmentation index (AIx) of the aortic pressure waveform using high-fidelity pulse wave analysis. Results: Daily sildenafil intake led to a significant sustained decrease in PWV and AIx, indicating a decrease in aortic stiffness and wave reflections (p < 0.05, figure). There were no significant changes in systolic and pulse pressure.

Conclusions

The present study shows for the first time that chronic treatment with sildenafil has a favourable effect on aortic stiffness and wave reflections in patients with ED. This finding may have important implications in patients with increased cardiovascular risk.