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However, myocardial ischemia lasting more than 10 min will cause nerve terminal ATP depletion, hypoxia, and a fall in intracellular pH, leading to massive, reverse transport through NET, with extracellular catecholamine accumulation up to 1001000 times greater than that in plasma ( 1 AR-mediated vasodilatation may disturb cardiac perfusion, particularly if combined with losartan, without having the desired effect on cardiac work load and cardiac energy consumption

Indian J Biochem Biophys 46:6672 Oudot A, Behr-Roussel D, Le Coz O et al (2010) How does chronic sildenafil prevents vascular, oxidative stress in insulin-resistant rats