Heart failure (HF) is the leading cause of morbidity and mortality and is evolving to epidemic proportions. Despite pharmacologic advances and device interventions, HF remains a progressive disease. The phosphodiesterase inhibitors-3 (PDE3I), and more recently, the phosphodiesterase inhibitors-5 (PDE5I) have been used as part of the treatment in certain patients, however, such combination has not been studied or reported before.