Abstract 3320: Graded Association Between Aortic Stiffness, Wave Reflections, and Duration of Vasculogenic Erectile Dysfunction: Linking Erectile Dysfunction With Generalized Vascular Disease
Objective: Aortic stiffness and wave reflections are markers of subclinical atherosclerosis and prognosticators of cardiovascular risk. Erectile dysfunction (ED) may be the early manifestation of a generalized vascular disease. We investigated the association between aortic stiffness, wave reflections and duration of ED.
Methods: A total of 244 men with ED (detected with a validated questionnaire) were studied: 75 men (62±9 yrs, mean time interval of ED = 3 years) with coronary artery disease (ED-CAD) and 169 men (59±11 yrs) without CAD. Men without CAD were divided into three groups, according to ED duration: Group A (<2 yrs, n=80), group B (2–3 yrs, n=44) and group C (>3 yrs, n=45). Aortic stiffness was evaluated with carotid-femoral pulse wave velocity (PWV) and wave reflections with augmentation index (AIx) of the aortic pressure waveform.
Results: PWV and AIx values were comparable among ED-CAD patients and patients with time interval longer than 3 years (group C) and higher of those in men of groups A and B (P<0.01, for both, figure⇓). In men without CAD, there was a stepwise augmentation in aortic stiffness and wave reflections throughout increasing duration of ED. This last relationship remained significant in multivariate analysis (P<0.05 by ANCOVA) after adjusting for age, mean pressure, heart rate, height, smoking, metabolic profile and C-reactive protein).
Conclusion: In patients with ED, the longer duration of ED, the greater impairment of aortic elastic properties and the higher augmentation of the aortic pressure waveform. These findings may partially elucidate the complex mechanisms linking ED with generalized vascular disease and increased cardiovascular risk.