title: Erectile dysfunction in healthy subjects predicts reduced coronary flow velocity reserve.
abstract: BACKGROUND
  Erectile dysfunction is associated with, and may be the first sign of coronary artery disease. We aimed to assess whether men with erectile dysfunction but without cardiovascular disease have reduced coronary flow reserve, as a sign of early coronary atherosclerosis.
  
  
  METHODS
  We investigated 12 men aged 68-73 years with erectile dysfunction, and 12 age-matched controls. Erectile function was evaluated using the validated IIEF-5 questionnaire. A score < or = 18 (of 25) was defined as erectile dysfunction and > or = 21 was considered normal. Patients with neurological or psychological reasons for erectile dysfunction were excluded, as were patients with symptoms of or prescribed medication for cardiovascular disease, hypertension or diabetes. Coronary flow velocity reserve was measured non-invasively by Doppler in the left anterior descending artery, before and during adenosine infusion.
  
  
  RESULTS
  Coronary flow velocity reserve was significantly reduced in subjects with erectile dysfunction: 2.36 versus 3.19; P=0.024. In logistic regression analysis, compared to control subjects, men with erectile dysfunction had significantly increased risk of reduced coronary flow velocity reserve (< or = 3.0): odds ratio 15.4, P=0.02. In multivariate analysis, adjusting for age, tobacco use, systolic blood pressure, heart rate and body mass index, erectile dysfunction was the only significant predictor of reduced coronary flow velocity reserve, P=0.016.
  
  
  CONCLUSIONS
  Men with erectile dysfunction but without diabetes or clinical cardiovascular disease have early signs of coronary artery disease. Our findings suggest that a cardiac risk evaluation may be indicated in men with suspected vasculogenic erectile dysfunction, and these individuals should be considered for primary prevention measures regarding cardiovascular disease risk factors.
authors.affiliation: Department of Cardiology, Lund University, University Hospital, Malmö, Sweden. rasmus.borgquist@med.lu.se
authors.forename: Rasmus
authors.initials: R
authors.lastname: Borgquist
authors.forename: Petri
authors.initials: P
authors.lastname: Gudmundsson
authors.forename: Reidar
authors.initials: R
authors.lastname: Winter
authors.forename: Peter
authors.initials: P
authors.lastname: Nilsson
authors.forename: Ronnie
authors.initials: R
authors.lastname: Willenheimer
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000502:physiology*; D004730:Endothelium, Vascular / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012307:Risk Factors