Document Detail

Vasculogenic erectile dysfunction is a predictor of abnormal stress echocardiography.
MedLine Citation:
PMID:  19170867     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Erectile dysfunction (ED) and atherosclerotic vascular disease have the same risk factors; furthermore, endothelial dysfunction has been shown to be a common link between these conditions. A high prevalence of silent coronary artery disease (CAD) in patients with ED has been observed. AIMS: The aims of this article were to define the prevalence and identify predictors of occult obstructive CAD in patients with documented vasculogenic ED. MAIN OUTCOME MEASURES: Duplex Doppler penile ultrasonography (DUS); exercise stress echocardiography; IIEF; CAD risk factors. Methods. Patients presenting with ED who had penile vascular insufficiency documented by DUS and who had no history of diabetes or symptoms of CAD were prospectively enrolled for noninvasive cardiac stress testing using exercise stress echocardiography. RESULTS: Forty-nine men (mean age 517 years) with an average duration of ED of 2.52 years were evaluated. Penile arterial insufficiency was present in 94%, and venous leak in 20% of patients. Comorbidities included hypertension (51%), hyperlipidemia (41%), and smoking (35%). All patients had at least one vascular risk factor, with 40% having two, 15% three, and 15% four risk factors. Ten patients (20%) had abnormal cardiac stress test. On univariate analysis, age, IIEF-EF domain score, cavernosal artery insufficiency, presence of venous leak, and history of a first-degree relative with CAD were significant predictors. On multivariate analysis, cavernosal artery insufficiency, venous leak, and family history of CAD continued to be predictors of an abnormal stress test. CONCLUSIONS: A significant proportion of men with vasculogenic ED have abnormal cardiac stress test. The greatest chance for abnormal cardiac stress test was observed in those with corporo-venocclusive dysfunction or family history of CAD. In some men presenting with ED, even without a CAD history, performing penile DUS or cardiology referral for stress testing should be considered.
John Mulhall; Patrick Teloken; Jennifer Barnas
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Publication Detail:
Type:  Journal Article     Date:  2009-01-09
Journal Detail:
Title:  The journal of sexual medicine     Volume:  6     ISSN:  1743-6109     ISO Abbreviation:  -     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-16     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101230693     Medline TA:  J Sex Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  820-5     Citation Subset:  IM    
Memorial Sloan-Kettering Cancer Center-Urology, New York, NY 10021, USA.
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MeSH Terms
Coronary Artery Disease / diagnosis*,  epidemiology*
Hyperlipidemias / epidemiology
Hypertension / epidemiology
Impotence, Vasculogenic / diagnosis,  epidemiology*
Middle Aged
Penis / ultrasonography
Predictive Value of Tests
Prospective Studies
Risk Factors
Smoking / epidemiology
Stress, Physiological*
Ultrasonography, Doppler, Duplex

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