Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis

Elesber, Ahmad A.; Solomon, Hemant; Lennon, Ryan J.; Mathew, Verghese; Prasad, Abhiram; Pumper, Geralyn M.; Nelson, Rebecca E.; McConnell, Joseph P.; Lerman, Lilach O.; Lerman, Amir

doi:10.1093/eurheartj/ehi749

Cited by 93 publications

(64 citation statements)

References 46 publications

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“…Previous studies demonstrated the relationship between plasma ADMA levels and the degree of endothelial dysfunction of forearm vascular beds in patients who were undergoing maintenance hemodialysis (30) and in hypertensive patients (31). Furthermore, coronary endothelial dysfunction is independently associated with the plasma ADMA concentration in men with early coronary atherosclerosis (32). Although reduced renal function is associated with attenuated coronary vasodilator capacity in patients with nonobstructive coronary artery disease (33), no investigation has examined the endothelial function of the coronary artery in CKD.…”

Section: Discussionmentioning

confidence: 99%

Role of Nitric Oxide–Producing and–Degrading Pathways in Coronary Endothelial Dysfunction in Chronic Kidney Disease

Tatematsu¹,

Wakino²,

Kanda³

et al. 2007

Journal of the American Society of Nephrology

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Section: Discussionmentioning

confidence: 99%

Role of Nitric Oxide–Producing and–Degrading Pathways in Coronary Endothelial Dysfunction in Chronic Kidney Disease

Tatematsu¹,

Wakino²,

Kanda³

et al. 2007

Journal of the American Society of Nephrology

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“…In various pathological states, such as hypercholesterolaemia, hyperglycaemia, hyperhomocysteinaemia, HTA and CAD, plasma levels of ADMA may be increased and lead to inhibition of NO synthesis and endothelial dysfunction Elesber et al (2006), Wierzbicki et al (2006). Thus, ADMA could be used as a biochemical indicator of endothelial dysfunction, as it seems to be responsible for the pathophysiological link between this condition and ED Wierzbicki et al (2006).…”

Section: Discussionmentioning

confidence: 99%

210 Endothelial function in patients with metabolic syndrome and erectile dysfunction: A question of Angiopoietin imbalance?

Tomada¹,

Tomada²,

Botelho³

et al. 2013

European Urology Supplements

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SUMMARYErectile dysfunction (ED) is a highly prevalent disease whose aetiology is mostly vasculogenic. It is nowadays considered a marker of future cardiovascular events reflecting the underlying endothelial dysfunction, the common link with the metabolic syndrome (MetS). The recent association between MetS, endothelial dysfunction and peripheral artery disease, but not with coronary artery disease (CAD), suggests that the pathophysiologies of CAD and peripheral artery disease may be distinct. Moreover, several recent studies support an emerging role for an imbalance of angiogenic growth factor levels like Angiopoietin 1 and 2 in cardiovascular disease, considering its intimate association with chronic low-grade inflammation. We aim to find a correlation between Angiopoietins levels and systemic and local endothelial function in MetS and ED patients. Forty-five MetS patients with ED were enrolled. ED severity was assessed by International Index of Erectile Function questionnaire (IIEF5) and penile duplex Doppler ultrasound (PDDU). Endothelial function was assessed by Peripheral arterial tonometry (PAT), and serum asymmetric dimethylarginine (ADMA), Ang1 and Ang2 levels. Obesity and hypertension were the most frequent MetS parameters (91.1 and 88.9% respectively). Severe ED was present in 35.6% of patients. Penile haemodynamic was impaired in 77.5%. Endothelial dysfunction (PAT criteria) was present in 40.9% of patients. Ang2 levels were significantly higher in men with abdominal obesity. We observed an inverse correlation between Ang1 and peak systolic velocity, and in patients with penile arterial dysfunction, Ang1 levels were significantly higher and Ang2/Ang1 ratio significantly lower, than patients with normal arterial function. Neither ADMA nor PAT parameters were correlated with ED severity evaluated by IIEF5 or PDDU exam. In conclusion, there is an imbalance of angiopoietins in MetS and ED patients. The absence of correlation with PAT or ADMA levels suggests that angiopoietins may be early markers of endothelial dysfunction in this population of higher cardiovascular risk.

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“…Since the publication of the algorithm in 2005, additional research studies have further supported the advisory panel recommendations. 6 Primary care physicians should be the key clinicians to screen for ED. This study is an observational study with a small sample size; for that reason, further multi-centre studies are recommended to stress on the following questions: Should an enquiry about sexual health, as a reflection of vascular health, be part of routine physicals for young men?…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a paucity of information regarding the prevalence and relationship between ED and early coronary atherosclerosis. 6 The presence of ED should prompt an aggressive assessment of occult vascular disease; many men with erectile difficulty would benefit from an early, aggressive management of cardiovascular risk factors, with both lifestyle modifications and pharmacotherapy to achieve optimal target goals under existing treatment guidelines. 7,8 The aim of this study was to determine the cardiovascular risk factors among men with ED attending a hospitalbased primary care clinic in Riyadh, Saudi Arabia.…”

Section: Introductionmentioning

confidence: 99%

Should an inquiry about sexual health, as a reflection of vascular health, be part of routine physicals for young men? Results from an outpatient study

Turki

2009

Int J Impot Res

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The objective of this study was to determine the cardiovascular risk factors among men with erectile dysfunction (ED) at a hospital-based primary care clinic in Riyadh, Saudi Arabia. A cross-sectional study was conducted at a primary care clinic in the King Khalid University Hospital (Riyadh, Saudi Arabia), during the period from January to March 2009. Verbal consent was obtained from the attending patients. All patients attending a consultant primary care clinic were interviewed and asked about the presence of ED. Cardiovascular risk factors such as diabetes, hypertension, dyslipidaemia and smoking were determined during consultation. Data entry and analysis were performed using the Statistical Package for Social Sciences (SPSS) version 11.5. A P-value o0.05% was considered significant. A total of 264 men were studied. The estimated prevalence of ED was 18.9%, and only 28% of them had consulted their physician regarding their problem. The prevalence of ED increased with old age, 64% of men with ED were aged X60 years. Diabetes mellitus, hypertension, dyslipidaemia and smoking were common cardiovascular risk factors among men with ED. Using medications for chronic illnesses such as diabetes, hypertension and dyslipidaemia was common among men with EDs (98%). Diabetes mellitus, hypertension, dyslipidaemia and smoking are common cardiovascular risk factors among men with ED. Early diagnosis and management of cardiovascular risk factors at an early stage might help to decrease the prevalence of ED. Facilitating patients to talk with their treating physicians regarding sensitive issues such as ED during consultation will help patients to seek proper and safe medical advice. Further research at multi-centres to study the relationship between cardiovascular risk factors and ED is recommended.

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Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis

Abstract: CED is independently associated with ED and plasma ADMA concentration in men with early coronary atherosclerosis. This study further supports the role of the endothelium in systemic vascular diseases and the role of ADMA in the systemic manifestations of endothelial dysfunction.

Cited by 93 publications

References 46 publications

Role of Nitric Oxide–Producing and–Degrading Pathways in Coronary Endothelial Dysfunction in Chronic Kidney Disease

Role of Nitric Oxide–Producing and–Degrading Pathways in Coronary Endothelial Dysfunction in Chronic Kidney Disease

210 Endothelial function in patients with metabolic syndrome and erectile dysfunction: A question of Angiopoietin imbalance?

Should an inquiry about sexual health, as a reflection of vascular health, be part of routine physicals for young men? Results from an outpatient study

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