Testing endothelial function of brachial and cavernous arteries in patients with erectile dysfunction.
BACKGROUND
There is considerable clinical and scientific evidence that endothelial dysfunction may be an important clinical link connecting erectile dysfunction (ED) with cardiovascular diseases.


OBJECTIVE
To modify the method of assessment of endothelial function of cavernosal arteries, to develop a new algorithm for evaluating its results, and to investigate the relationship between postocclusive changes in the diameter of brachial and cavernous arteries.


METHODS
The study participants were 212 patients presenting to our department complaining of ED and 40 healthy volunteers without sexual problems, which formed the control group. All patients with ED underwent complex evaluation and ultrasound assessment of postocclusive changes in the diameter of cavernosal arteries modified by us and standard ultrasound assessment of endothelium-dependent flow-mediated dilation of the brachial artery.


METHODS
As the main outcome measure, the percent of increase of the cavernosal arteries diameter (PICAD) was recorded.


RESULTS
In the patients with arteriogenic ED, PICAD values were significantly less than in other groups (P < 0.001 for pairs of comparison). At the same time there were no differences between the control group and groups of patients with psychogenic and organic nonarterial ED. The sensitivity and specificity of a PICAD value of 50% in diagnosis of arteriogenic ED were 100% and 98.2%, respectively. In all groups and in the entire sample of patients studied we did not find a correlation between PICAD and postocclusive changes in the diameter of brachial arteries.


CONCLUSIONS
The method of ultrasound assessment of postocclusive changes in the diameter of cavernosal arteries is reliable and a highly informative tool for diagnosis of arteriogenic ED. It cannot be substituted by technically simpler method of ultrasound examination of brachial arteries, while results of the latter could help to define the necessity of performing an examination of cavernous arteries.
Department of Urology, Russian State Medical University, Moscow, Russia. efax@rambler.ru
Evsey
E
Mazo
Safar
S
Gamidov
Stanislav
S
Anranovich
Vycheslav
V
Iremashvili
D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000473:pathology; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D014463:Ultrasonography; D014664:Vasodilation