Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease

Abstract

Objective:Heart rate recovery (HRR) is a recognised marker used in clinical practice for assessing the risk of sudden cardiac death. Physical exercise leads to an improvement in HRR and has a proven beneficial effect on erection quality (EQ) related to the activity of the autonomic nervous system in men with ischaemic heart disease (IHD). This paper evaluates the relationship between HRR and EQ in patients with IHD and erectile dysfunction (ED) who underwent cardiac rehabilitation.Methods:The main analysis was based on the Mann–Whitney U test, Wilcoxon signed-rank test, Spearman correlation coefficient, Pearson’s chi-square test, chi-square test, with the Yates correction and (if possible) parametric tests were used. This prospective, non-randomised intervention study included 124 men with IHD and ED [International Index of Erectile Function (IIEF-5) scores of ≤21]. Of these, 89 patients underwent a 6-month cardiac rehabilitation phase III programme, whereas 35 did not. The results of the participants’ total IIEF-5 scores and their HRR, demographic and clinical data were analysed.Results:The results of the 89 rehabilitated patients (mean age: 60.44±9.29 years) and 35 controls (mean age: 61.43±8.81 years) were analysed. In the rehabilitated patients, the mean baseline IIEF-5 score was 13.15±5.76 (95% CI: 11.93–14.36) and HRR was 16.49±7.68/min (95% CI: 14.88–18.11). After cardiac rehabilitation, the parameters of ED and HRR improved significantly and were significantly higher than those of the controls; the mean IIEF-5 score of the rehabilitated group increased to 15.36±6.51 (95% CI: 13.99–16.73), while HRR increased to 21.40±7.25/min (95% CI: 19.88–22.93). A significant correlation was found between ∆HRR and ∆EQ (r=0.409791) as a result of the 6-month cardiac training programmeConclusion:Cardiac rehabilitation assessed by HRR has a sizable effect on autonomic balance in patients with IHD and ED, which plays a significant role in the mechanism of erection improvement.

Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies

“…The ED score was “mild” at baseline for the intervention and control groups in 5 studies ( Table 3 ). In contrast to the control groups, the intervention groups in the 3 studies by Kalka et al 51 , 52 , 53 achieved an improvement of erectile function, which remained in the category “mild.” In Maio et al 47 and Khoo et al, 48 the control groups also achieved an improvement in erectile function, but the improvement of the control groups was not as high as in the intervention groups.…”

“…After examining the full texts of these articles, 42 studies were excluded because the requested data were not reported, leading to the inclusion of 10 studies. 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55

Figure 1 Flowchart of data collection process. IIEF = International Index of Erectile Function.

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“…1 study did not report the IIEF-5 score for the control group but reported that the outcome IIEF-5 score did not differ from the baseline IIEF-5 score. 53 Another study did not report the mean IIEF-5 score at follow-up for the intervention or control group. 55 However, the study reported that, at baseline, 34% and 36% of men in the intervention and control groups, respectively, had normal erectile function and that, at follow-up, 56% and 38% of men in the intervention and control groups, respectively, had normal erectile function.…”

“…The study by Begot et al 54 and the 3 studies by Kalka et al 51 , 52 , 53 represented studies of men with CVD and ED. In the study by Begot et al, the target group was treated for acute myocardial infarction, and in the studies by Kalka et al, the target groups were invasively treated for ischemic heart disease.…”

“…Only 1 study had PA intensity of mild to moderate. 52 In 4 studies, 51 , 52 , 53 , 55 the moderate aerobic PA exercises were supplemented with resistance training programs.…”