Document Detail

Cutaneous microcirculatory function predicts the responsiveness to tadalafil in patients with erectile dysfunction and coronary artery disease.
MedLine Citation:
PMID:  17703223     Owner:  NLM     Status:  MEDLINE    
Despite the proven clinical efficacy of phosphodiesterase inhibitors in the treatment of erectile dysfunction (ED), some patients do not respond to the medication. By means of nailfold capillary microscopy in patients with concomitant coronary artery disease (CAD) and ED, it was evaluated whether the extent of microvascular dysregulation predicts the responsiveness to tadalafil (TAD) in terms of erectile function. The ED of each patient was assessed by the International Index of Erectile Function (IIEF). Patients presenting both, documented CAD and ED, showed a significantly reduced capillary red blood cell velocity (v(RBC)) at rest and after 3 min of ischemia compared with age-matched controls. At 2 h after intake of 20 mg of TAD, a significant increase of v(RBC) at rest as well as during postischemic hyperemia was found. Patients who reported no improvement of their ED after the use of TAD demonstrated no changes in the duration of postischemic (DpH) hyperemia, or even a reduction of the DpH. The majority of the patients, who reported at least one successful sexual intercourse due to TAD, had a prolongation of DpH. We conclude that assessment of microvascular regulation by nailfold capillary microscopy can predict the probability of a treatment failure with phosphodiesterase inhibitors in patients with ED. Moreover, as endothelial dysfunction is the common underlying pathophysiological process of ED and cardiovascular diseases, the test may help to identify patients at risk for the development of atherosclerosis and following cardiovascular events.
J-W Park; B Leithäuser; C Mrowietz; F Jung
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-08-16
Journal Detail:
Title:  International journal of impotence research     Volume:  20     ISSN:  1476-5489     ISO Abbreviation:  Int. J. Impot. Res.     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007383     Medline TA:  Int J Impot Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  150-6     Citation Subset:  IM    
Cardiology/Angiology Division, Hoyerswerda Hospital, Hoyerswerda, Germany.
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MeSH Terms
Blood Flow Velocity
Carbolines / pharmacology*
Coronary Angiography
Coronary Artery Disease / complications
Endothelium, Vascular / physiopathology
Erectile Dysfunction / complications,  drug therapy*
Microcirculation / drug effects*,  physiopathology
Middle Aged
Phosphodiesterase Inhibitors / pharmacology*
Predictive Value of Tests
Skin / blood supply*,  physiopathology
Reg. No./Substance:
0/Carbolines; 0/Phosphodiesterase Inhibitors; 0/tadalafil

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