Peripheral vascular disease and erectile dysfunction as predictors of mortality in heart failure patients.
BACKGROUND
Seventy percent to 90% of patients with heart failure (HF) report erectile problems. There are no published data on whether erectile dysfunction (ED) and peripheral vascular disease (PVD) correlate with mortality in HF patients. Also, little is known regarding the impact of HF etiology on mortality in patients with ED.


OBJECTIVE
Our aim was to investigate the relationship between ED and mortality in HF patients, to evaluate whether the etiology of HF carries a prognostic measure in patients with ED, and to assess the impact of PVD on mortality in optimally treated HF patients with ED.


METHODS
The measures are: (i) mortality by presence or absence of ED; (ii) mortality by HF etiology and presence or absence of ED; and (iii) PVD and mortality in HF patients on optimal medical therapy with ED.


METHODS
This is a single-center, prospective cohort study of 328 male HF patients (ejection fraction < or = 40%) followed while being treated with optimal doses of beta blockers and angiotensin-converting enzyme inhibitors. The Sexual Health Inventory for Men survey was used to assess ED (no ED > or = 22 and ED < or = 21). Ankle brachial index (ABI) was used to assess PVD (normal ABI > or = 0.9 and abnormal ABI < 0.9).


RESULTS
Kaplan-Meier curves were constructed to examine the relationship between the presence or absence of ED and PVD, and mortality in a HF population. Although not statistically significant, a trend for increased risk of death was demonstrated in the ischemic cardiomyopathy cohort with ED.


CONCLUSIONS
ED, highly prevalent in this cohort, did not identify HF patients on optimal medical therapy at increased risk for mortality. Among the HF patients with ED, HF type was not associated with increased risk for mortality whereas PVD was independently associated with a statistically significant increase in mortality.
Hebert
Kathy
K
Cardiovascular Division, Disease Management and Outcomes Research, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL 33136, USA.
Lopez
Barbara
B
Macedo
Francisco Yuri Bulcao
FY
Gomes
Conrado Rios
CR
Urena
Johan
J
Arcement
Lee M
LM
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D055109:Ankle Brachial Index; D006306:Health Surveys; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality*; D006439:Hemodynamics; D006801:Humans; D018783:Impotence, Vasculogenic; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors