Erektil disfonksiyonu olan hastalarda ventriküler repolarizasyon parametrelerinin değerlendirilmesi

Year 2025, Volume: 6 Issue: 4, 422 - 427, 31.08.2025

Oğuzhan Baran , Yücel Yılmaz , Numan Baydilli , Halis Yılmaz , Şaban Keleşoğlu

https://doi.org/10.47582/jompac.1724214

Abstract

Amaç; Erektil disfonksiyon (ED), orta yaşlı ve yaşlı erkekleri etkileyen vaskülojenik bir hastalıktır. ED, gelecekteki kardiyovasküler hastalıkların (KVD) iyi bir öngörücüsü olarak kabul edilir. Ayrıca, EKG'deki ventriküler repolarizasyon parametrelerinin çeşitli hastalıklar için artmış ventriküler aritmogenezi ve ani ölümle ilişkili olduğunu gösteren çalışmalar da vardır. Bu çalışmada, ED ile Tp-e/QTc oranı, Tp-e/QT oranı ve Tp-e aralığı arasındaki ilişki araştırılacaktır.
Yöntemler: Çalışmaya hastanemizin üroloji kliniğine başvuran vasküler ED tanısı almış 87 hasta dahil edildi. Tp-e aralığı, T dalgasının tepe noktası ile T dalgasının sonu arasındaki mesafe olarak tanımlandı.
Bulgular: Tp-e aralığı, Tp-e/QT oranı ve Tp-e/QTc oranı, ED hastalarında kontrol grubuna kıyasla istatistiksel olarak anlamlı derecede yüksekti (genel p <0.01). Korelasyon analizimiz, ED'li hastalarda IIEF-5 skoru ile Tp-e aralığı, Tp-e/QT oranı ve Tp-e/QTc oranı arasında anlamlı negatif korelasyonlar buldu (sırasıyla r=-0,714, p<0,001; r=-0,729, p<0,001, r=-0,776, p<0,001).
Sonuç: EKG'de ölümcül ventriküler aritmiler için önemli olduğu düşünülen Tp-e aralığı, Tp-e/QT oranı ve Tp-e/QTc oranının ED hastalarında anlamlı şekilde daha uzun olduğunu bulduk.

Keywords

Seksüel fonksiyon , Tp-e aralığı , Tp-e/QT oranı , Tp-e/QTc oranı

Evaluation of ventricular repolarization parameters in patients with erectile dysfunction

Abstract

Aims: Erectile dysfunction (ED) is recognized as a good predictor of future cardiovascular disease (CVD). There are also studies showing that ventricular repolarization parameters on Electrocardiography (ECG) are associated with increased ventricular arrhythmogenesis and sudden death for various diseases. In this study, we will investigate the relationship between ED and Tp-e to QTc ratio, Tp-e interval/QT interval (Tp-e/QT) ratio and Tp-e interval.
Methods: The study included 87 patients admitted to the urology clinic of our hospital and diagnosed with vascular ED. The distance between the peak of the T wave and the end of the T wave was defined as the Tp-e interval. QT interval was defined as the interval from the beginning of the QRS complex to the end of the T wave and adjusted according to heart rate (QTc, Bazett formula).
Results: Tp-e-QTc ratio, Tp-e-QT ratio and Tp-e interval were statistically and significantly higher in patients with ED compared to the control group (overall p<0.01). Our correlation analysis found significant negative correlations between IIEF-5 score and Tp-e-QTc ratio, Tp-e-QT ratio and Tp-e interval in patients with ED (r=-0.714, p<0.001; r=-0.729, p<0.001, r=-0.776, p<0.001, respectively).
Conclusion: We found that Tp-e/QTc ratio, Tp-e/QT ratio and Tp-e interval, which are considered to be important for fatal ventricular arrhythmias on ECG, were significantly longer in emergency department patients.

Keywords

Sexual function , Tp-e to QTc ratio , Tp-e to QT ratio and Tp-e interval

References

• Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004
• Uddin SMI, Mirbolouk M, Dardari Z, et al. Erectile dysfunction as an independent predictor of future cardiovascular events: the multi-ethnic study of atherosclerosis. Circulation. 2018;138(5):540-542. doi:10.1161/CIRCULATIONAHA.118.033990
• Chokesuwattanaskul R, Thongprayoon C, Pachariyanon P, et al. Erectile dysfunction and atrial fibrillation: a systematic review and meta-analysis. Int J Urol. 2018;25(8):752-757. doi:10.1111/iju.13725
• Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart. 2003;89(3):251-253. doi:10.1136/heart.89.3.251
• Guo Y, Lip GYH, Apostolakis S. Inflammation in atrial fibrillation. J Am Coll Cardiol. 2012;60(22):2263-2270. doi:10.1016/j.jacc.2012.04.063
• Liu T, Meng XY, Li T, Fu ZL, Zhao SG, Yao HC. Atherosclerosis is critical in the pathogenesis of erectile dysfunction. Int J Cardiol. 2016;203:367-368. doi:10.1016/j.ijcard.2015.10.187
• Vlachopoulos C, Aznaouridis K, Ioakeimidis N, et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J. 2006;27(22):2640-2648. doi:10.1093/eurheartj/ehl341
• Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol. 2008;41(6):567-574. doi:10.1016/j.jelectrocard.2008.07.016
• Selvi F, Korkut M, Bedel C, Kuş G, Zortuk Ö. Evaluation of Tpeak-end interval, Tpeak-end/QT, and Tpeak-end/Qtc ratio during acute migraine attack in the emergency department. Acta Neurol Belg. 2024;124(3):949-955. doi:10.1007/s13760-024-02497-x
• Yılmaz Y, Keleşoğlu Ş, Gökay F. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios in patients with primary hyperparathyroidism and their relationship with cardiac arrhythmic events. Turk J Med Sci. 2022;52(2): 397-404. doi:10.55730/1300-0144.5326
• Smetana P, Schmidt A, Zabel M, et al. Assessment of repolarization heterogeneity for prediction of mortality in cardiovascular disease: peak to the end of the T wave interval and nondipolar repolarization components. J Electrocardiol. 2011;44(3):301-308. doi:10.1016/j.jelectrocard. 2011.03.004
• Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol. 2008;41(6):575-580. doi:10.1016/j.jelectrocard.2008.07.030
• Turgay Yıldırım Ö, Kaya Ş, Baloğlu Kaya F. Evaluation of the Tp-e interval and Tp-e/QTc ratio in patients with benign paroxysmal positional vertigo in the emergency department compared with the normal population. J Electrocardiol. 2020;58:51-55. doi:10.1016/j.jelectrocard.2019.11.002
• Akboğa MK, Gülcihan Balcı K, Yılmaz S, et al. Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy. Anatol J Cardiol. 2017;18(1):48-53. doi:10.14744/AnatolJCardiol.2017.7581
• Castro Hevia J, Antzelevitch C, Tornés Bárzaga F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47(9):1828-1834. doi:10.1016/j.jacc.2005.12.049
• Yılmaz S, Kuyumcu MS, Akboga MK, et al. The relationship between erectile dysfunction and paroxysmal lone atrial fibrillation. J Interv Card Electrophysiol. 2016;46(3):245-251. doi:10.1007/s10840-016-0115-8
• Platek AE, Hrynkiewicz-Szymanska A, Kotkowski M, et al. Prevalence of erectile dysfunction in atrial fibrillation patients: a cross-sectional, epidemiological study. Pacing Clin Electrophysiol. 2016;39(1):28-35. doi: 10.1111/pace.12753
• Akkus E, Kadioglu A, Esen A, et al. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol. 2002;41(3): 298-304. doi:10.1016/s0302-2838(02)00027-1
• Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7(2):79-108. doi:10.1016/j.euje. 2005.12.014
• Ponholzer A, Temml C, Obermayr R, Wehrberger C, Madersbacher S. Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol. 2005;48(3):512-518. doi:10.1016/j.eururo. 2005.05.014
• Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med. 2003; 139(3):161-168. doi:10.7326/0003-4819-139-3-200308050-00005
• Eaton CB, Liu YL, Mittleman MA, Miner M, Glasser DB, Rimm EB. A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men. Int J Impot Res. 2007;19(2):218-225. doi:10.1038/sj.ijir.3901519
• Gazzaruso C, Giordanetti S, De Amici E, et al. Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients. Circulation. 2004;110(1):22-26. doi:10.1161/01.CIR.0000133278.81226.C9
• Kirby M, Jackson G, Simonsen U. Endothelial dysfunction links erectile dysfunction to heart disease. Int J Clin Pract. 2005;59(2):225-229. doi:10. 1111/j.1742-1241.2005.00453.x
• Feldman HA, Johannes CB, Derby CA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med. 2000;30(4):328-338. doi:10.1006/pmed.2000.0643
• Jackson G, Boon N, Eardley I, et al. Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus. Int J Clin Pract. 2010;64(7):848-857. doi:10.1111/j.1742-1241.2010.02410.x
• Gandaglia G, Briganti A, Jackson G, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014;65(5):968-978. doi:10.1016/j.eururo.2013.08.023
• Fung MM, Bettencourt R, Barrett-Connor E. Heart disease risk factors predict erectile dysfunction 25 years later: the Rancho Bernardo Study. J Am Coll Cardiol. 2004;43(8):1405-1411. doi:10.1016/j.jacc.2003.11.041
• Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2011;58(13):1378-1385. doi:10.1016/j.jacc.2011.06.024
• Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005;294(23):2996-3002. doi:10.1001/jama.294.23.2996
• Lin WY, Lin CS, Lin CL, Cheng SM, Lin WS, Kao CH. Atrial fibrillation is associated with increased risk of erectile dysfunction: a nationwide population-based cohort study. Int J Cardiol. 2015;190:106-110. doi:10. 1016/j.ijcard.2015.04.108
• Tanaka Y, Bundy JD, Allen NB, et al. Association of erectile dysfunction with incident atrial fibrillation: the multi-ethnic study of atherosclerosis (MESA). Am J Med. 2020;133(5):613-620.e1. doi:10.1016/j.amjmed.2019. 08.052
• Altunkol A, Topuz AN, Genç Ö, Alma E, Topuz M. Atrial electromechanical duration prolongs in patients with erectile dysfunction. Aging Male. 2020;23(2):154-160. doi:10.1080/13685538.2019. 1650336
• Schouten BWV, Bohnen AM, Bosch JLHR, et al. Erectile dysfunction prospectively associated with cardiovascular disease in the Dutch general population: results from the Krimpen study. Int J Impot Res. 2008;20(1):92-99. doi:10.1038/sj.ijir.3901604
• Tse G, Yan BP. Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death. Europace. 2017; 19(5):712-721. doi:10.1093/europace/euw280
• Tzeis S, Asvestas D, Yen Ho S, Vardas P. Electrocardiographic landmarks of idiopathic ventricular arrhythmia origins. Heart. 2019;105(14):1109-1116. doi:10.1136/heartjnl-2019-314748
• Kirby M, Jackson G, Betteridge J, Friedli K. Is erectile dysfunction a marker for cardiovascular disease? Int J Clin Pract. 2001;55(9):614-618. doi:10.1111/j.1742-1241.2001.tb11141.x
• Roumeguère T, Van Antwerpen P, Fathi H, et al. Relationship between oxidative stress and erectile function. Free Radic Res. 2017;51(11-12): 924-931. doi:10.1080/10715762.2017.1393074
• Acar G, Yorgun H, Inci MF, et al. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with ankylosing spondylitis. Mod Rheumatol. 2014; 24(2):327-330. doi:10.3109/14397595.2013.854072
• Mountantonakis S, Deo R. Biomarkers in atrial fibrillation, ventricular arrhythmias, and sudden cardiac death. Cardiovasc Ther. 2012;30(2):e74-80. doi:10.1111/j.1755-5922.2010.00238.x