The phosphodiesterese-5 (PDE5) inhibitors, including sildenafil (Viagra™), vardenafil (Levitra™), tadalafil (Cialis™) and
avanafil (Stendra™) have been developed for the treatment of erectile dysfunction. Moreover, sildenafil and tadalafil have been approved
for the management of pulmonary arterial hypertension. A number of preclinical studies have shown that PDE5 inhibitors have powerful
protective effect against several clinical scenarios including myocardial ischemia/reperfusion injury, doxorubicin and post-MI, heart failure,
cardiac hypertrophy, heart transplantation, Duchenne muscular dystrophy and preconditioning of stem cells. Based on these studies,
it appears that sildenafil and other PDE5 inhibitors hold promise for further development as novel drug therapies in cardioprotection.