Nicola Galea MD, Presenter: Nothing to Disclose

Iacopo Carbone MD, Abstract Co-Author: Nothing to Disclose

Elisa Giannetta, Abstract Co-Author: Nothing to Disclose

Federica Ciolina, Abstract Co-Author: Nothing to Disclose

David Cannata, Abstract Co-Author: Nothing to Disclose

Andrea Isidori, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

More than 7 percent of the population in the United States have diabetes and cardiovascular disease remains the most important complication. Diabetic cardiomiopathy is a not-well know cardiac complication and represents a good model of endothelial dysfunction. It is characterized by an impairment of diastolic performance resulting in hypertrophic ventricular dilatation and reduction of ejection fraction. The purpose of our study was to evaluate by Cardiac MRI (CMR) the impact on cardiovascular performance of a three-months treatment with Sildenafil, a selective phosphodiesterase 5 inhibitors (PDE5i).

We designed a randomized, placebo-controlled, double blind (subject/outcome assessor) study on chronic treatment (3 months) with high dose of Sildenafil (100 mg/in 3 daily doses). We have enrolled 50 diabetic men (35-75 yrs), metabolically controlled; 2 patients drop out the study (1 for dyspepsia, 1 for non-compliance). All patients performed a CMR exam (cineMR and Contrast Enhanced-IR) before and after 3 months of therapy. All data were analysed by using Argus software (Siemens) to assess end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), cardiac output (CO), ejection fraction (EF) and myocardial mass (MyoM). Segmental kinesis of whole left ventricular was also evaluated. Safety monitoring was taken monthly at follow-up visits.

CMR results showed a significant improvement of heart remodelling parameter with an increase of EDV, EF, SV, CO and hypokinetic areas); not significant changes of myocardial mass was observed. Clinical monitoring reveals a significant improvement of cardiovascular risk parameters (post prandial glycemia, HDL cholesterol, systolic and diastolic blood pressure).

Diabetic Cardiomiopathy in asymptomatic patients in characterized by an increase of EDV and a reduction of EF. CMR is an ideal tool in follow-up of diabetic patient after therapy with Sildenafil, thanks to its high accuracy and reproducibility.

CardiacMR, thanks to the high accuracy and reproducibility, can well demonstrate the improvement of cardiac performance after a three-months Sildenafil therapy in patients with Type II Diabetes.

Galea, N, Carbone, I, Giannetta, E, Ciolina, F, Cannata, D, Isidori, A, Catalano, C, Passariello, R, et al, 0, Cardiovascular Effects of Chronic Sildenafil Treatment in Men with Type 2 Diabetes by Cardiac MRI Evaluation.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010661.html