Volume 15, Issue 5 (September 2013) 15, 652–657; doi: 10.1038/aja.2013.15
Impaired flow-mediated vasodilatation in Asian Indians with erectile dysfunction
Tanuj Bhatia1, Aditya Kapoor1, Jatinder Kumar2, Archana Sinha1, Priyadarshi Ranjan2, Sudeep Kumar1, Naveen Garg1, Satyendra Tewari1, Aneesh Srivastava2, Rakesh Kapoor2 and Pravin K Goel1
1Departments of Cardiology, Sanjay Gandhi PGIMS, Lucknow 226014, India 2Urology and Renal Transplantation, Sanjay Gandhi PGIMS, Lucknow 226014, India
Correspondence: Dr A Kapoor, (akapoor65@gmail.com)
Received 28 November 2012; Revised 17 January 2013; Accepted 25 January 2013 Advance online publication 27 May 2013
Abstract |
Endothelial dysfunction is the postulated link between coronary artery disease (CAD) and erectile dysfunction (ED). Brachial artery flow-mediated vasodilatation (FMD) is a non-invasive surrogate marker for endothelial function assessment. Despite Asian Indians representing a considerable global CAD burden, data on FMD and ED in these patients are lacking. Of the 225 patients undergoing coronary angiography, 72% had ED (assessed using the International Index of Erectile Function (IIEF-5) questionnaire); ED was moderate to severe in 61% of the patients. ED patients had a higher incidence of severe and diffuse angiographic CAD, a greater number of coronary vessels involved and a lower mean brachial artery FMD (6.40%±4.60% vs. 9.10%±4.87%, P<0.001) compared to non-ED patients. A progressive reduction in FMD was noted with increasing severity of ED. Impaired FMD (≤5.5%) was twice as common in ED patients (52% vs. 24% without ED). Patients with impaired FMD had higher ED prevalence (85% vs. 62%) and lower mean IIEF-5 scores compared to those with normal FMD. Impaired FMD was a significant ED predictor independent of other risk factors (odds ratio, 2.33; 95% confidence interval: 0.59–9.23; P=0.03). An inverse correlation between FMD and ED severity was observed (r=−0.22; P=0.004). ED is common among Asian Indians with angiographically documented CAD. Patients with ED have impaired FMD independent of other risk factors, suggesting that endothelial dysfunction is the underlying pathophysiology. Urologists and cardiologists need to be aware of the association between ED, CAD and endothelial dysfunction.
Keywords:
Asian Indians; brachial artery flow mediated vasodilatation; erectile dysfunction
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