Dynamic penile peak systolic velocity predicts major adverse cardiovascular events in hypertensive patients with erectile dysfunction

Ioakeimidis, N.; Vlachopoulos, Charalambos; Rokkas, K.; Kratiras, Z.; Angelis, Athanasios; Samentzas, Alexis; Fassoulakis, C.; Tousoulis, Dimitris

doi:10.1097/hjh.0000000000000877

Cited by 12 publications

(10 citation statements)

References 36 publications

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“…The calculation of the sample size ( n = 300) was performed using the two‐tailed long‐rank test, setting at 85% (Ioakeimidis et al ., ) the survival to major adverse cardiovascular events for subjects with ED and PSV>30 cm/sec vs. a 74% for subjects with PSV<30 cm/sec (HR:1.85) with (1−β) = 80% and α = 5%.…”

Section: Methodsmentioning

confidence: 94%

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

et al. 2018

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Background: Traditional risk factors used to assess cardiovascular risk miss a significant population who are indeed at risk for future cardiac events. Erectile dysfunction (ED) is an emerging marker for future cardiovascular disease (CVD) and major adverse cardiovascular events (MACE), especially in young and middle-aged men with vasculogenic ED. Cavernous arteries morphological alterations at penile colour doppler ultrasound (P-CDU) are used to find a vasculogenic ED. Objectives: We investigated the possible relationship between cavernous arteries morphological alterations at P-CDU assessment and future MACE. Materials and methods: We conducted a retrospective cohort study involving 300 ED patients, aged 35-65 years (mean age 54.1 AE 7.1), with a follow-up period of 10 years. Patients underwent vascular evaluation including P-CDU, colour doppler ultrasound of the carotid and lower limbs arteries. At baseline data for glucose metabolism, lipid profile, hypertension and hormonal status were collected. During the follow-up period, the occurrence of MACE was evaluated. Results: We found a strong association between cavernous arteries morphological alterations and CVD with a threefold increased risk of future MACE in comparison to patients with healthy cavernous arteries (RR 3.2, 95% CI 1. 17-8.78). This association remained statistically significant after adjustment for CV risk factors (age, glycaemia, total cholesterol, hypertension and smoke). Conclusions: Morphological alterations of cavernous arteries are independently associated with an increased risk of future MACE. These data contribute to the formulation of the hypothesis that cavernous artery pathology at P-CDU is related to MACE.

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Section: Methodsmentioning

confidence: 94%

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

et al. 2018

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“…This technique is not mandatory for establishment of a diagnosis of ED in all patients (Hatzimouratidis et al, 2010), especially in the era of highly effective orally active agents for the treatment of ED. However, in the context of the link between ED and cardiovascular health, it represents an essential procedure (Foresta et al, 2008;Caretta et al, 2009;Ioakeimidis et al, 2016;Rastrelli et al, 2016). P-CDU allows quantification of different parameters commonly used in vascular diagnostics, of which cavernous peak systolic velocity (PSV) represents the most important to diagnose the patient's penile vascular status (Ioakeimidis et al, 2016;Rastrelli et al, 2016).…”

Section: How Diagnosis Of Ed and Vasculogenic Ed In Particular Is Mmentioning

confidence: 99%

“…However, in the context of the link between ED and cardiovascular health, it represents an essential procedure (Foresta et al, 2008;Caretta et al, 2009;Ioakeimidis et al, 2016;Rastrelli et al, 2016). P-CDU allows quantification of different parameters commonly used in vascular diagnostics, of which cavernous peak systolic velocity (PSV) represents the most important to diagnose the patient's penile vascular status (Ioakeimidis et al, 2016;Rastrelli et al, 2016). Importantly, reduced cavernous PSV is associated with increased risk of CVD (Ioakeimidis et al, 2016;Rastrelli et al, 2016).…”

Section: How Diagnosis Of Ed and Vasculogenic Ed In Particular Is Mmentioning

confidence: 99%

“…The vasculogenic nature of ED and the need for a cardiovascular workup is confirmed by dynamic penile color doppler ultrasonography (P-CDU) after pharmacologically induced erection (Ioakeimidis et al, 2016;Rastrelli et al, 2016). This technique is not mandatory for establishment of a diagnosis of ED in all patients (Hatzimouratidis et al, 2010), especially in the era of highly effective orally active agents for the treatment of ED.…”

Section: How Diagnosis Of Ed and Vasculogenic Ed In Particular Is Mmentioning

confidence: 99%

“…P-CDU allows quantification of different parameters commonly used in vascular diagnostics, of which cavernous peak systolic velocity (PSV) represents the most important to diagnose the patient's penile vascular status (Ioakeimidis et al, 2016;Rastrelli et al, 2016). Importantly, reduced cavernous PSV is associated with increased risk of CVD (Ioakeimidis et al, 2016;Rastrelli et al, 2016). Indeed, P-CDU data include also information on acceleration time, end-diastolic velocity, resistive index, measurement of intima-media thickness (IMT) and stenosis, and therefore represents a real cardiovascular imaging technique that give evidence on the presence of systemic endothelial dysfunction and atherosclerosis (Foresta et al, 2008;Caretta et al, 2009).…”

Section: How Diagnosis Of Ed and Vasculogenic Ed In Particular Is Mmentioning

confidence: 99%

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The great opportunity of the andrological patient: cardiovascular and metabolic risk assessment and prevention

2017

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Andrologists, cardiologists and diabetologists (and general practitioners) have the great opportunity to collaborate and find shared clinical workup for the benefit of a large number of men. Several evidence established a link between erectile dysfunction (ED), cardiovascular disease (CVD), diabetes, and metabolic syndrome. Not only these conditions share many risk factors and pathophysiological mechanisms but also an emerging paradigm indicates that ED is, in fact, an independent marker of cardiovascular disease risk, CV events and CV mortality. However, there is no consensus on the best cardiologic investigation in men with ED with no known CVD and, on the contrary, on what is the clinical and prognostic role of detecting ED during cardiovascular investigation and CVD risk assessment. Only vasculogenic ED, which represents the most common type of organic ED, indeed represents a harbinger of CVD, especially for younger patients, and might be diagnosed by dynamic penile color doppler ultrasonography, which represents a real cardiovascular imaging technique that give evidence on the presence of systemic endothelial dysfunction and atherosclerosis. Furthermore, assessment of glucose and lipid metabolism is warranted as first step workup in all ED patients, and diabetologists should ask their patients for erectile function, address ED patients to andrologists, and consider vasculogenic ED in the context of the cardiovascular and metabolic workup and in the context of diabetic complications. Sexual symptoms (and testosterone levels) should sound as harbinger for cardiovascular and metabolic investigation and cardiologists and diabetologists have the opportunity to have a symptom (erectile dysfunction) and a vascular test (penile color doppler) that help them in better management of patients, their comorbidities and complications.

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Risks of High Blood Pressure and Goals for Treatment

Fuchs

2017

Essentials of Hypertension

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Dynamic penile peak systolic velocity predicts major adverse cardiovascular events in hypertensive patients with erectile dysfunction

Abstract: Low-penile blood flow predicts MACE in hypertensive patients free of clinical atherosclerosis. This predictive ability is independent of the severity of hypertension and decreased testosterone that is often present in such patients.

Cited by 12 publications

References 36 publications

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

Penile doppler ultrasound predicts cardiovascular events in men with erectile dysfunction

The great opportunity of the andrological patient: cardiovascular and metabolic risk assessment and prevention

Risks of High Blood Pressure and Goals for Treatment

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