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Eli Lilly's Cialis (Tadalafil) is better known as a treatment for erectile dysfunction. But scientists at the University of Manchester are interested in proving that they can reverse heart failure, and a study on sheep offers encouraging evidence that they may be right.
Cialis slowed the progression of heart failure in sheep models and reversed shortness of breath, one of the most bothersome symptoms, researchers reported in Scientific Reports.
The results may not be a total surprise. This class of drugs, the PDE5 inhibitors, which also includes Pfizer Viagra and Bayer Levitra, was originally developed for heart disease. Next, scientists developing Viagra discovered the drug against erectile dysfunction.
"We have limited evidence from human trials and epidemiological studies that show that Tadalafil may be effective in the treatment of heart failure," said Andrew Trafford, principal author of the study, in a statement. "This study provides further confirmation, adds mechanical details and demonstrates that tadalafil could now be a possible treatment for heart failure."
Heart failure is characterized by the heart's inability to pump enough blood to meet the needs of the body, which can lead to fluid build-up in the lungs and a feeling of shortness of breath. The Trafford team used sheep to study the effects of PDE5 inhibition because their hearts were similar to the human heart.
After causing heart failure in animals, the team administered Cialis at a dose similar to that used to treat ED in humans. They observed that Cialis restored the heart's ability to react to adrenaline, which improved its ability to pump blood.
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Most drugs for heart failure can slow the progression of the disease and reduce the risk of fatal heart events. But, in reality, it is difficult to reverse heart failure, especially without surgery or medical assistance.
Different groups of scientists are exploring methods to reverse heart failure with drugs. A team from Imperial College London recently discovered that blocking MAP4K4 protein could reduce heart damage. In a Nature study in 2017, researchers at Baylor College of Medicine discovered that the Hippo signaling pathway could prevent damaged heart muscle from repairing itself and that by blocking it, they restored the pumping capacity of the heart of the mice.
But researchers at the University of Manchester believe that the best strategy could be to return to the initial goal of inhibiting PDE5.
"We seem to have come full circle, with the results of recent studies suggesting that [ED drugs] can be effective in treating some forms of heart disease – in this case, heart failure, "said Metin Avkiran, deputy medical director of the British Heart Foundation, who funded the study. "Evidence from this study, that a drug similar to Viagra could reverse heart failure, should encourage new research in humans to determine if such drugs can help save and improve lives. "
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