Lol . Is it that obvious ? Just in the past few months I ' ve read the Birth of Tragedy , The Genealogy of Morals , The Gay Science , and I am half way through Thus Spoke Zarathustra now . <| sep |> This is probably the most relevant partEffects of Sildenafil on Cardiac Response to Stress . Evolving data suggest that inhibition of PDE 5 may have important antihypertrophic , antiapoptotic , and ischemic preconditioning effects that may limit myocardial remodeling in response to stress and attenuate the substrate for heart failure development . In murine models of myocardial pressure overload induced by aortic banding , inhibition of PDE 5 is associated with reduction of cardiac and myocyte hypertrophy , reduction in interstitial fibrosis , preservation of cardiac function , and the deactivation of various hypertrophy signaling cascades . PDE 5 inhibition also promotes opening of mitochondrial KATP channels , a putative target of reactive oxygen species generated in response to both ischemiareperfusion IR and doxorubicin treatment , and reduces doxorubicin or i schemiareperfusioninduced apoptosis . 18 , 19 Accordingly , administration of sildenafil appears both to limit the size of myocardial infarction generated during ischemiareperfusion , and to attenuate the development of left ventricular dysfunction in murine models of doxorubicin cardiotoxicity . 5 , 1921