Age-matched cavernous peak systolic velocity: a highly sensitive parameter in the diagnosis of arteriogenic erectile dysfunction

Abstract

Recently it has been reported that there is a strict correlation between erectile dysfunction (ED) and cardiovascular diseases, but the importance of such relationship still needs to be addressed. Ultrasonographic peak systolic velocity (PSV), is considered a reliable parameter for the diagnosis of arteriogenic ED. However, the cut-off value of PSVo30 cm/s has sufficient sensitivity only in the diagnosis of advanced arteriogenic ED and it is not representative of peripheral vascular alterations. In the present study, we set up an age-adjustment of PSV -calculated with the formula PSV o6.73 þ age  0.7 -that permits a more accurate diagnosis of vascular aetiology in ED patients and may predict the presence of carotid wall alterations. We studied 179 consecutive subjects (mean age 52 years, range 23-79 years), with a history of ED of at least 6 months, by means of penile colour doppler ultrasonography (P-CDU) and common carotid arteries colour doppler ultrasonography (CCA-CDU) between June 2003 and September 2004. Statistical analysis was carried out with the statistical software R. PSV and CCAD values showed a statistically significant negative correlation. Age adjustment further improved this relationship permitting to identify an age-dependent PSV cutoff given by the formula PSV o6.73 þ age  0.7. The age-adjusted PSV cut-off allows an accurate interpretation of vascular aetiology in ED patients and predicts the presence of carotid wall alterations, from the intima-media pathologic thickness to the plaque formation, with high values of both sensitivity and specificity.

Re: Penile duplex pharmaco‐ultrasonography of cavernous arteries in men with erectile dysfunction and generalized atherosclerosis

“…In agreement with our previous data, they found that the peak systolic velocity (PSV) cut‐off value of 30 cm/sec, is not appropriate to identify ED patients with peripheral vascular disease (Speel et al. , 2003; Caretta et al. , 2006).…”

“…The authors found a correlation between cavernous PSV and carotid atherosclerosis and between PSV and age. Recently we described the same results (Caretta et al. , 2006).…”

Metabolic Syndrome and Erectile Dysfunction

“…Limitations involve difficulties in the recruitment of control subjects. In fact, the administration of alprostadil only for study purpose in subjects without ED could be detrimental, and we did not find cavernosal wall alterations in the absence of ED (7). An early screening for MS in patients with ED might identify individuals with higher risk for cavernosal and systemic atherosclerosis.…”

“…Cavernosal peak systolic velocity (PSV) and intima-media thickness (IMT) were measured, and penile vasculopathy was classified (7). Carotid and femoral arterial IMT was calculated (8).…”

Association of Total Atherosclerotic Burden with Progression of Penile Vascular Disease

“…18,19 While previous studies have shown an association between PSV of cavernous arteries and either carotid or femoral IMT, [20][21][22] there are no reports linking PSV measures to global atherosclerotic burden. This study uses a score that incorporates IMT measurements and the presence and size of plaques from both the carotid and femoral arteries to assesses the presence of a correlation between the extent of penile vascular disease and the global atherosclerotic burden.…”