Amino-terminal pro-C-type natriuretic peptide is associated with the presence, severity, and duration of vasculogenic erectile dysfunction.
BACKGROUND
Endothelial dysfunction is a key event in the pathophysiology of erectile dysfunction (ED) and generalized vascular disease. C-type natriuretic peptide (CNP) is a paracrine molecule that effects endothelial integrity and vascular tone.


OBJECTIVE
To determine the role of CNP in men with vasculogenic ED.


METHODS
Fifty-two consecutive men (age: 57+/-10 yr) with nonpsychogenic and nonhormonal ED for >6 mo and free of cardiovascular disease who were referred to the Cardiovascular Diseases and Sexual Health Unit of our Department for evaluation of ED were compared with 31 subjects with normal erectile function matched for age, body mass index, and traditional risk factors.


METHODS
Vasculogenic ED was diagnosed according to comprehensive history, physical examination, Sexual Health Inventory for Men (SHIM-5) scoring, hormonal testing, and penile color-Doppler ultrasound. Amino-terminal proCNP (NT-proCNP) was measured in plasma with enzyme-linked immunosorbent assay (ELISA).


CONCLUSIONS
Compared to controls, ED patients had significantly lower NT-proCNP levels (0.21+/-0.08 pmol/l in ED patients vs 0.34+/-0.07 pmol/l in control subjects; p<0.001). NT-proCNP levels were associated with erectile performance as expressed by SHIM-5 score (r=0.57; p<0.001), even after adjusting for confounders. There was also an inverse linear relationship between ED duration and NT-proCNP levels (p<0.05). In patients with arteriogenic ED, there was a positive correlation of NT-proCNP levels with peak systolic velocity (PSV) (r=0.51; p=0.01).


CONCLUSIONS
CNP levels are associated with the presence, severity, and duration of ED. These findings provide further insight into the role of CNP in the pathophysiology of ED.
Vlachopoulos
Charalambos
C
Cardiovascular Diseases and Sexual Health Unit, 1st Department of Cardiology, Athens Medical School, Athens, Greece. cvlachop@otenet.gr
Ioakeimidis
Nikolaos
N
Terentes-Printzios
Dimitrios
D
Rokkas
Konstantinos
K
Aznaouridis
Konstantinos
K
Baou
Katerina
K
Bratsas
Athanasios
A
Fassoulakis
Charalambos
C
Stefanadis
Christodoulos
C
D006801:Humans; D018783:Impotence, Vasculogenic / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D012720:Severity of Illness Index; D013997:Time Factors
C480579:amino-terminal pro-C-type natriuretic peptide, human; D020098:Natriuretic Peptide, C-Type