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Furthermore, several clinical studies have confirmed the potential role of sildenafil in improving cardiac output, endothelial function, muscle perfusion, and exercise ventilatory and aerobic efficiencies in systolic HF patients [158,159,160]

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Food & Nutrition Research, 65

NF-B signaling pathway The NF-B signaling pathway plays a pivotal role in biological processes such as the immune response, cell proliferation, and apoptosis

If there is no signal at four weeks in a compliant patient, the probability of benefit with continued use is low