Microvascular endothelial dysfunction predicts the development of erectile dysfunction in men with coronary atherosclerosis without critical stenoses

Martin Reriani, Andreas J. Flammer, Jing Li, Megha Prasad, Charanjit Rihal, Abhiram Prasad, Ryan Lennon, Lilach O. Lerman, Amir Lerman

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Background: Erectile dysfunction (ED) is associated with an increased risk for cardiovascular disease, stroke, and allcause mortality, independent of conventional cardiovascular risk factors. Coronary endothelial dysfunction is independently associated with ED in men with early coronary atherosclerosis. We aimed to investigate whether coronary microvascular dysfunction predicts development of ED in patients presenting with coronary atherosclerosis without critical stenoses. Patients and methods: Coronary microvascular function was evaluated in 130 men with coronary atherosclerosis without critical stenoses by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4 years, patients were assessed for the development of ED by administration of a questionnaire. Results: In all, 68 (50%) men had microvascular endothelial dysfunction at baseline; 35 (51%) men with microvascular endothelial dysfunction developed ED on follow-up compared with 19 (31%) men without microvascular endothelial dysfunction. Men who developed ED had a lower coronary blood flow response (% ΔCBF) compared with men who did not develop ED, with mean ± SD of 25.4 ± 71.3 versus 81.7± 120 (P=0.003). In univariate analysis, microvascular endothelial dysfunction was a predictor for the development of ED, with relative risk of 2.4 (1.2-4.9) (P=0.016). In multivariate logistic regression adjusting for traditional cardiovascular risk factors (age, hypertension, hyperlipidemia, diabetes, vascular disease, and family history of coronary artery disease), only microvascular endothelial dysfunction (P=0.027) and age (P=0.044) remained significant predictors of development of ED. Conclusion: Coronary microvascular dysfunction is a predictor of the development of ED in men with coronary atherosclerosis without critical stenoses. This study underscores the systemic involvement of the endothelial function in vascular disease.

Original languageEnglish (US)
Pages (from-to)552-557
Number of pages6
JournalCoronary Artery Disease
Volume25
Issue number7
DOIs
StatePublished - 2014

Keywords

  • Endothelium
  • Erectile dysfunction
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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