Peak systolic velocity in patients with arterial erectile dysfunction and peripheral arterial disease

Vicari, Enzo; Pino, Luigi Di; Vignera, Sandro La; Fratantonio, E; Signorelli, Salvatore Santo; Battiato, C; Calogero, Aldo E.

doi:10.1038/sj.ijir.3901387

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…Men with ED and both carotid and lower limb abnormalities had the most severe penile artery disease based on ultrasound assessments of all three vascular beds. 30 Both of these studies support the concept that many men with vascular ED should be regarded as having generalized vascular atherosclerosis. Additional evaluation of the carotid and lower limb peripheral vascular beds may help to identify men who, after presenting with ED as their initial clinical symptom, would benefit from additional diagnostic testing and/or aggressive pharmacologic intervention for risk factor management.…”

Section: Erectile Dysfunction As a Harbinger Of Cvd Kl Billups Et Alsupporting

confidence: 66%

Erectile dysfunction as a harbinger for increased cardiometabolic risk

et al. 2008

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In August 2003, the Minority Health Institute (MHI) convened an Expert Advisory Panel of cardiologists and urologists to design a new practice model algorithm that uses erectile dysfunction (ED) as a clinical tool for early identification of men with systemic vascular disease. The MHI algorithm noted ED as a marker for the presence of cardiovascular disease and suggested that ED may well be a cardiovascular risk equivalent warranting aggressive secondary prevention management strategies, even in the absence of other cardiac or peripheral vascular symptoms. The MHI algorithm stipulates that all men 25 years of age and older should be asked about ED as a routine part of the cardiovascular history during any office visit. The presence of ED should prompt an aggressive assessment for occult vascular disease; many men with erectile difficulty would benefit from early, aggressive management of cardiovascular risk factors with both lifestyle modification and pharmacotherapy to achieve optimal target goals under the existing treatment guidelines. Since publication of the algorithm in 2005, additional research studies have further supported the advisory panel recommendations.

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Section: Erectile Dysfunction As a Harbinger Of Cvd Kl Billups Et Alsupporting

confidence: 66%

Erectile dysfunction as a harbinger for increased cardiometabolic risk

et al. 2008

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“…The authors did not describe clinical methods for LEAD diagnosis, and did not control for blood pressure. In the other two studies [12, 13], the authors reported that narrowing of the larger lower extremity arteries (based on Doppler ultrasound) was more common in men with ED, and that men with lower extremity arterial narrowing and ED had significantly worse penile arterial insufficiency; they did not report small-vessel LEAD or control for any covariates.…”

Section: Discussionmentioning

confidence: 99%

“…Little attention has been paid to the association between ED and LEAD, although they share common cardiovascular risk factors including age, diabetes, hypertension, dyslipidemia, sedentary lifestyle, obesity, alcohol use, and smoking [4–6], as well as endothelial dysfunction [7] and inflammation [8–10]. None of the three studies that have reported the association between ED and LEAD have specifically addressed the independent ED association with small-vessel LEAD [11–13]. …”

Section: Introductionmentioning

confidence: 99%

Small-vessel lower extremity arterial disease and erectile dysfunction: The Rancho Bernardo study

2009

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Objective-Although erectile dysfunction (ED) has been associated with heart disease risk factors and large-vessel lower extremity arterial disease (LEAD), no community-based studies have reported the association between ED and small-vessel LEAD, despite the similar size of the arteries affected. We examined whether small-vessel LEAD is associated with ED, and whether this association is independent of cardiovascular risk factors and medications.Methods and Results-Community-dwelling men, average age 71, completed the International Index of Erectile Function-5 questionnaire and had measurements recorded of toe-brachial index (TBI), a measure of small-vessel LEAD. TBI, 12 cardiovascular risk factors, and medications were used as categorical predictors in age-adjusted bivariate analyses, and as continuous covariates in multivariable linear regression analyses, to determine their independent association with severity of ED.In the age-adjusted categorical model, the level of TBI (low, medium, high) was associated with the severity of ED (β = 0.364; 95% CI: 0.102, 0.625). In the final multivariable linear regression model, which controlled for age and systolic blood pressure, lower TBI (i.e., more severe small-vessel LEAD) was significantly and independently associated with more severe ED (β = 0.422; 95% CI: 0.019, 0.826).Conclusions-The severity of small-vessel LEAD is significantly and independently associated with the severity of ED. The mechanism for this association remains to be determined, but these data are compatible with the hypothesis that concurrent ED and small-vessel LEAD signify a diffuse microvascular process involving multiple small-vessel arterial beds.

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“…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.…”

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confidence: 98%

Association of Total Atherosclerotic Burden with Progression of Penile Vascular Disease

IoakeimidisNikolaos¹,

TsokanisAthanasios²,

VlachopoulosCharalambos³

et al. 2014

Journal of Men's Health

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Background: Erectile dysfunction (ED) is an early manifestation of a generalized arterial disease. The association between penile vascular disease progression and total atherosclerotic burden was investigated using a classification that incorporates ultrasonographic assessments of intima media thickness (IMT) and plaques from both the carotid and femoral arteries. Methods: Sixty-five ED patients (mean age, 56 -10 yrs) were evaluated for cavernous vascular disease severity using penile Doppler ultrasound. Ultrasonographic assessments of IMT, lumen diameter, and plaques in the carotid and femoral arteries were evaluated, and patients were classified according to an ultrasound-based morphological system. Results: Based on the results of ultrasonic assessments, patients were divided into two groups-a high-score group and a low-score group. Patients in the high-score group had increased intima-media ( > 1.0 mm) and/or plaque in any of the four arteries. Patients in the low-score group had normal carotid and femoral IMT and an absence of plaques in all four arteries. While the two groups did not differ in blood pressure parameters, metabolic profile, and smoking status, high-score patients (n = 31) had significantly decreased age-adjusted peak systolic velocity (25.2 cm versus 32.3 cm/s, P < 0.01) and a longer duration of ED (3.8 years versus 2 years, P < 0.05), compared with low-score patients (n = 34). In the high-score group, score level was inversely correlated with peak systolic velocity after adjusting for age and systolic blood pressure (b = -0.322, P = 0.025). There also was a positive linear relation of ED duration with prevalence of high score (P < 0.05). Conclusions: In patients with vasculogenic ED, ultrasound findings of penile vasculature damage and longstanding ED correlate significantly with increasing carotid and femoral atherosclerotic burden. These data suggest a close interrelationship between progression of vasculogenic ED and peripheral atherosclerosis.

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Peak systolic velocity in patients with arterial erectile dysfunction and peripheral arterial disease

Cited by 13 publications

References 24 publications

Erectile dysfunction as a harbinger for increased cardiometabolic risk

Erectile dysfunction as a harbinger for increased cardiometabolic risk

Small-vessel lower extremity arterial disease and erectile dysfunction: The Rancho Bernardo study

Association of Total Atherosclerotic Burden with Progression of Penile Vascular Disease

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