Erectile dysfunction as manifestation of endothelial changes in coronary artery disease patients


By academic.oup.com

The study was aimed at examining the relationship between endothelial and erectile dysfunctions (ED) in coronary artery disease (CAD) patients.

Material: The study included 184 males with stable CAD at the age of 55.8±5.3 years. The erectile function was assessed using the International Index of Erectile Function questionnaire, version 5 (IIEF-5). Clinical assessment included postcompression tests of the brachial and cavernous arteries. Postcompression tests were done using the ALOKA ProSound SSD-α10 ultrasound machine (Japan).

Results: According to the IIEF-5 questionnaire all the patients were divided into two groups: with erectile dysfunction (127 patients) and with preserved erectile function (57 patients). The assessment of flow-mediated vasodilation (FMVD) of the brachial artery after reactive hyperemia showed that the blood flow velocity and the diameter of the brachial artery were similar in the groups.

The increase in the blood flow velocity during reactive hyperemia caused a 6% increase in the brachial artery diameter in patients with preserved erectile function while the erectile dysfunction-CAD group had only 3% increase. Mean FMVD of the brachial artery was 6.4±3.5% in patients with preserved erectile function, 1.4-fold higher than in those with erectile dysfunction (p=0.03).

The diameter of the cavernous artery increased, on average, by 28% as a response to reactive hyperemia in no ED group while the ED group had a 16% increase (p=0.02). The percent of cavernous artery diameter increase was twice as high in the no-ED group than in the ED group. Then FMVD was assessed in relation to the severity of ED. Patients with more severe ED had a more pronounced endothelial dysfunction as compared to those with mild ED. This manifested in significantly lower FMVD of the brachial artery (2.36±1.92 and 6.58±2.7% respectively, p=0.0001) and lower percent of cavernous artery diameter increase after reactive hyperemia (4.64±2.56 and 35.99±6.39% respectively, p=0.0001).

Conclusion: This study suggests the presence of impaired endothelial vasoregulation, which is a manifestation of more pronounced endothelial function impairment in males with CAD and ED.

Source: https://academic.oup.com/eurheartj/article/34/suppl_1/2779/2861328/Erectile-dysfunction-as-manifestation-of

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