Abstract 3120: Penile Arterial Insufficiency and Long-standing Erectile Dysfunction are Associated both Independently and Additively with Increased Aortic Stiffness and Carotid Intima Media Thickness
Aortic stiffness and carotid intima media thickness (IMT) are markers of cardiovascular risk. The severity of the penile arterial insufficiency and the duration of erectile dysfunction (ED) are predictors of cardiovascular disease in patients with vasculogenic ED. We investigated the combined effect of increased duration of ED and severe arterial insufficiency (SAI) on aortic stiffness and carotid IMT. A total of 171 ED patients underwent penile Doppler, carotid-femoral pulse wave velocity (c-f PWV) and carotid IMT evaluation. Mean peak systolic velocity (PSV) values below 25 cm/sec are considered to indicate SAI. Patients with SAI (n = 53) compared to those without SAI (n = 118) had higher c-f PWV and IMT (by 1.1 m/s and 0.17 mm, respectively, P<0.001 for both). Patients with long-standing ED (>3 years) (n = 61) compared to patients with a duration of less than 3 years (n = 110) had higher c-f PWV and IMT (by 0.6 m/s and 0.8 mm, respectively, P<0.05 for both). Stepwise regression analysis showed that age, systolic BP, duration of ED and SAI were independent predictors of c-f PWV and IMT. In patients with an ED duration of less than 3 years, SAI patients (n = 29) had increased c-f PWV and IMT (by 0.5 m/s and 0.12 mm, respectively, P<0.05 for both, figure⇓) compared to non-SAI patients (n = 80). Similarly in patients with long-standing ED (>3 years), SAI patients (n = 24) had higher c-f PWV and IMT (by 1.9 m/s, P<0.001 and 1.5 mm, P<0.05, respectively) compared to non-SAI patients (n = 38). Severely impaired penile vascular hemodynamics and long standing ED are independently and additively associated with increased aortic stiffness and carotid IMT.