Is Erectile Dysfunction an Early Indicator of Cardiovascular Disease

Abstract

Objectives: Our aim was to evaluate cardiovascular health who applied to our clinic for erectile dysfunction. These patients neither had any history of cardiovascular disease nor used medical or surgical treatment for atherosclerotic coronary artery disease. Material and Methods: 100 male patients had been included for this study that were applied to our clinic for erectile dysfunction and planned to be started sildenafil sitrate. As a diagnosis criteria we used the first 5 questions of International Index for Erectile Function and the patients whose score was below 21, were included to our study. We performed blood chemistry, profile of hormones and penile doppler ultrasonography to all patients. The patients had been performed holter monitorisation. Electrocardiography, ecocardiography, myocard perfusion sintigraphy with talium and coronary angiography were performed to the patients according to neccessity who had ST segment depression seems to be ischemia. Results: Mean ages of patients were 50.0±13.0 (22-76). Further investigations were performed to 40 patients who had ST depression seems to be ischemia according to the results of Holter Monitorisation. According to the results of these investigations 3 patients were (3%) transferred for coronary bypass operation. 25 patients (25%) have been diagnosed as atherosclerotic coronary artery disease and medical treatment was started to these patients. Conculation: ED patients with no history of symptomatic cardiovascular disease may have atherosclerotic coronary artery disease with significiant rates. Therefore, ED may be an early predictor for cardiovascular disease in many patients and we believe that these patients should be investigated carefully about cardiovascular diseases. ©2007, Firat University, Medical Faculty

Keywords

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Erektil Disfonksiyon Kardiyovasküler Hastalığın Erken Habercisi Olabilir mi?

Öz

Giriş: Erektil disfonksiyon (ED) nedeni ile başvuran ve öyküsünde herhangi bir kardiyovasküler hastalığı olmadığı ve/veya ASKH nedeniyle medikal ya da cerrahi tedavi almamış hastalarda kardiyovasküler patoloji yönünde araştırma yapmanın gerekliliğini araştırdık. Gereç ve Yöntem: Kliniğimize ED şikayeti ile başvuran ve medikal tedavi olarak sildenafil sitrat başlanması planlanan 100 erkek hasta çalışmada yer aldı. ED tanı kriteri olarak tüm hastaların Uluslararası Erektil Fonksiyon İndeksi'nin ilk beş sorusu (IIEF-5)'na göre skoru

Anahtar Kelimeler

• Erektil disfonksiyon, kardiyovasküler hastalık

References

1. NIH Consensus Conference: Impotence: NIH Consensus Development Panel on Impotence. JAMA 1993: 270; 83-88.
2. Laumann EO, Paik A, Rosen R: Sexual dysfunction in the United States: prevalance and predictors. JAMA 1999: 21; 537-544.
3. Feldman HA, Goldstein I, Hatzichristou DG, Krane J, McKinlay JB. Impotance and its medical and psyhosocial correlates: Results of the Massachusetts male aging study. J Urol 1994: 151; 54-61.
4. Akkus E, Kadıoglu A, Esen A, etal. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol 2002: 41: 298-304.
5. Lue TF. Erectile dysfunction. N Engl J Med 2000: 342; 18021813.
6. Bortolotti A, Parazzini F, Colli E, Landoni M. The epidemiology of erectile dysfunction and its risk factors. Int J Androl 1997: 20; 323-334.
7. Montorsi F, Briganti A, Salonia A, etal. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003: 44; 360-365.
8. Solomon H, Man JW, Wierzbicki AS, Jackson G: Relation of erectile dysfunction to angiographic artery disease. Am J Cardiol 2003: 91; 230-231.

9. Azadzoi KM, Goldstein I. Erectile dysfunction due to atherosclerotic vascular disease: the development of a animal model. J Urol 1992: 147; 1675-1681.
10. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The International Index of Erectile Function (IIEF):a multidimensional scale for assessment of erectile dysfunction. Urology 1997: 49; 822-830.
11. Jackson G. Erectile dysfunction and cardiovascular disease. Int J Clin Pract 1999: 53; 363-368.
12. Sullivan ME, Keoghane SR, Miller MA. Vascular risk factors and erectile dysfunction. BJU Int 2001: 87; 838-845.
13. Maas R, Schwedhelm E, Albsmeier J, Boger RH. The pathophysiology of erectile dysfunction related to endothelial dysfunction and mediators of vascular fucntion. Vasc Med 2002: 7; 213-225.
14. Bookstein JJ, Vanderberg J, Machado T. The cavernosal acetylcholine/papaverine response. A practical in vivo method for quantification of endothelium dependent relaxation. Invest Radiol 1990: 25; 1168-1174.
15. O’Kane PD, Jackson G. Erectile dysfunction:is there silent obstructive artery disease? Int J Clin Pract 2001: 55; 219-220.
16. Virag R, Bouilly P, Frydman D. Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet 1985: 1; 181-184.
17. Billups KL, Kaiser DR, Kelly AS, etal. Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res 2003: 15; 231-236.
18. Kaiser DR, Billups KL, Mason C, etal. Impaired brachial artery endothelium-dependent and independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004: 43; 179-184.
19. Pritzker MR. The penile stress test: a window to the hearts of man? Circulation 1999: 100; (suppl 1): 1-11.
20. Prisant LM, Loebl DH Jr, Waller JL. Arterial elasticity and erectile dysfunction in hypertensive men. J Clin Hypertens (Greenwich) 2006:8; 768-774.