6 months treatment with the medication Ramipril

Peripheral Arterial Disease

Ramipril therapy will start at 2.5mg/day for 1 week. Then 5mg/day for 1 week and will be increased to 10mg/day by the third week. The patients will stay on Ramipril 10mg/day for 22 weeks.

Ramipril

VA Medical Center

Ramipril Treatment of Claudication

Ramipril Treatment of Claudication: Oxidative Damage and Muscle Fibrosis

Maximum walking distance in meters per Gardner protocol

Maximum Distance in meters the patient can walk in 6 minutes on a flat, hard surface

The distance in meters the patient can walk before he experiences claudication pain, per Gardner protocol

Ratio of the blood pressure at the level of the ankle to the blood pressure at the level of the arm

Myofiber content of HNE adducts and protein carbonyls

Area in square microns, measured by immunofluorescence microscopy

Measured as ratio of major axis in microns to minor axis in microns

Measured as the ratio of myofiber area in square microns to the area of a fitted convex hull in square microns

Measured as the sum of the products of mean pixel intensity (in gray scale units) and area (in square microns) of each TGF-β1 labeled event divided by the total area (in square microns) of the tissue sample analyzed. Measured by immunofluorescence microscopy.

Measured as the area-weighted mean pixel intensity (in gray scale units) of all the collagen labeled events per tissue sample. Measured by bright-field microscopy.

Measured in microns by immunofluorescence microscopy of vessels labeled for collagen.

Number of capillaries per unit area (in square microns) of the tissue sample analyzed.

Iraklis I Pipinos, MD

Professor of Surgery

University of Nebraska

Placebo pill (identical to Sildenafil citrate 50mg), b.i.d.

Oral Sildenafil citrate, 50mg, b.i.d.
Sildenafil citrate: Oral sildenafil citratre, 50mg b.i.d., 8 weeks

Sildenafil Citrate

Placebo: Placebo pills similar to sildenafil citrate pills, b.i.d for 8 weeks

Sugar Pill

Total

Sex: Female, Male

Region of Enrollment

Finger blood flow of the four medial fingers, measured by laser Doppler imaging and expressed in arbitrary perfusion units (p.u.).

Digital skin microvascular blood flow measured by Laser Doppler Imaging (LDI) before cold stimulus

Finger blood flow of the four medial fingers, measured by laser Doppler imaging and expressed in arbitrary perfusion units (p.u.). Measure taken after submersion of both hands in water at 15°C for 1 minute.

Digital skin microvascular blood flow measured by Laser Doppler Imaging (LDI) after cold stimulus.

Daily frequency of RP attacks as self registered in a 1-week diary. Any episode of pallor or cyanosis of the hand/fingers was considered as a RP attack, and patients were supposed to register the daily amount of such episodes on a 1-week diary, previously to the medical visit.

Daily frequency of Raynuad's Phenomenon attacks

Digital Skin Microvascular Blood Flow Measured by Laser Doppler Imaging (LDI) Before Cold Stimulus

Digital Skin Microvascular Blood Flow Measured by Laser Doppler Imaging (LDI) After Cold Stimulus.

Daily Frequency of Raynaud's Phenomenon Attacks

Overall Study

Fernando Villela Andrigueti, MD

Scleroderma, Systemic

Scleroderma, Diffuse

Scleroderma, Limited

Raynaud Phenomenon

Oral sildenafil citratre, 50mg b.i.d., 8 weeks

Sildenafil citrate

Placebo pills similar to sildenafil citrate pills, b.i.d for 8 weeks

Placebo (Sugar pill)

Systemic Sclerosis Outpatient Clinic, Hospital Sao Paulo, UNIFESP

Effect of Sildenafil on the Microcirculatory Blood Flow and Endothelial Progenitor Cells in Systemic Sclerosis

Effect of Sildenafil on the Microcirculatory Blood Flow and on the Endothelial Progenitor Cells in Patients With Systemic Sclerosis: a Randomized, Double-blind, Placebo-controlled Clinical Trial

Fernando Villela Andrigueti

Federal University of São Paulo

Fundação de Amparo à Pesquisa do Estado de São Paulo

Hemodialysis Patients

Peripheral Vascular Disease

Cilostazol

Effects of Cilostazol on VEGF and Oxidative Stress Biomarkers in Hemodialysis Patients With Peripheral Vascular Disease

Effects of Cilostazol on Vascular Endothelial Growth Factor , Inflammatory and Oxidative Stress Biomarkers in Hemodialysis Patients With Peripheral Vascular Disease.

gangrene/hypoxia

Ramipril Treatment of Claudication

Effect of Sildenafil on the Microcirculatory Blood Flow and Endothelial Progenitor Cells in Systemic Sclerosis

Effects of Cilostazol on VEGF and Oxidative Stress Biomarkers in Hemodialysis Patients With Peripheral Vascular Disease

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