{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T03:44:01Z","timestamp":1794282241426,"version":"4.9.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Advanced heart failure (HF) is characterized by repeated hospital admissions due to recurring need for intravenous inotropes. Among the most commonly used medications used in this context, is milrinone, which increases the myocardial relaxation velocity, what is known as lusitropy. This effect is mediated by increasing cyclic adenosine monophosphate, which in turn switches on phospholamban (PLB) activity, an enzyme promoting calcium reuptake by the sarcoplasmic reticulum. The aim of this review is to shed light on oral medications that can play a similar role by alternative pathways. PLB can be as well stimulated by cyclic guanosine monophosphate (cGMP), the latter is known to be increased by medications which inhibit phosphodiesterase 5. Two well-established drugs can perform this action and are currently exclusively used as vasodilators, namely sildenafil and tadalafil. Another emerging hope is vericiguat; a medication that can directly stimulate guanylyl cyclase, leading to increase in cGMP. We speculate that the possible introduction of these oral medications is thought to replace the need for repeated hospital and intensive care admissions. This also might mean delaying the necessity for mechanical support or transplantations, which can change the face of advanced or end-stage HF.<\/jats:p>","DOI":"10.4103\/heartviews.heartviews_122_24","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T10:00:21Z","timestamp":1746871221000},"page":"255-259","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Repurposing Cyclic Guanosine Monophosphate Pathway Medications, from Vasodilation toward Changing the Face of Heart Failure"],"prefix":"10.4103","volume":"25","author":[{"given":"Antoine Fakhry","family":"AbdelMassih","sequence":"first","affiliation":[{"name":"Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt"},{"name":"Pediatric Cardiology Division, Department of Cardiac Sciences, SKMC, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buthaina","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Students\u2019 Research Program (Research Accessibility Team), Faculty of Medicine, 6October University, Cairo, Egypt"},{"name":"Pediatric Cardiology Observership Program, Cardiac Sciences Department, SKMC, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana Tarek","family":"ElDemerdash","sequence":"additional","affiliation":[{"name":"Students\u2019 Research Program (Research Accessibility Team), Faculty of Medicine, New Giza University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monia Mostafa","family":"Zayed","sequence":"additional","affiliation":[{"name":"Students\u2019 Research Program (Research Accessibility Team), Faculty of Medicine, New Giza University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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