Cerebral vasomotor reactivity is reduced in patients with erectile dysfunction.
BACKGROUND
Erectile dysfunction (ED) is not only evidence of diffuse atherosclerosis but also an index of early endothelial damage. We investigated cerebrovascular reactivity, expression of early arterial damage, in patients with isolated ED (ED+) and controls (ED-).


METHODS
Fifteen ED+ and 15 ED- subjects, matched for age (ED+: 58+/-6, ED-: 59 +/- 4 years) and vascular risk factors, were submitted to carotid duplex ultrasound and transcranial Doppler. Cerebrovascular reactivity was assessed on both middle cerebral arteries simultaneously calculating (a) the total vasomotor range (VMR) measured after breath holding and hyperventilation and (b) the rate of change (VMR/CO(2)) after breath holding.


RESULTS
Carotid Duplex scanning showed a light carotid stenosis only in 3 (2 in the ED+ and 1 in the ED- group). No differences were observed in intima-media thickness between ED+ and ED-. Slightly slower mean middle cerebral artery flow velocities were observed in ED+ with respect to ED-. ED+ patients showed a reduced VMR (p < 0.001) and a slower VMR/CO(2) rate of change (p < 0.001) compared to ED-.


CONCLUSIONS
The reduced reactivity in patients with isolated ED may represent a marker of early cerebral vasomotor dysfunction due to subclinical endothelial damage.
Department of Neurological Sciences, University of Rome, La Sapienza, Rome, Italy. edoardo.vicenzini@uniroma1.it
Edoardo
E
Vicenzini
Marta
M
Altieri
Paolo Maria
PM
Michetti
Maria Chiara
MC
Ricciardi
Mauro
M
Ciccariello
Hossein
H
Shahabadi
Francesco
F
Puccinelli
Gian Luigi
GL
Lenzi
Vittorio
V
Di Piero
D001783:Blood Flow Velocity; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015897:Comorbidity; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012306:Risk; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D018616:Ultrasonography, Doppler, Duplex; D017585:Ultrasonography, Doppler, Transcranial; D014666:Vasomotor System / Q000000981:diagnostic imaging / Q000503:physiopathology*