title: Effect of cardiac resynchronization therapy on libido and erectile dysfunction.
abstract: BACKGROUND
  Chronic heart failure (HF) is a common, complex clinical syndrome characterized by dyspnea, fatigue and exercise intolerance. HF patients experience decreased libido and erectile dysfunction (ED). The effects of cardiac resynchronization therapy (CRT) on libido and erectile function have not been previously evaluated. We aimed to investigate the effects of CRT on libido and ED.
  
  
  OBJECTIVE
  Cardiac resynchronization therapy improves libido and ED.
  
  
  METHODS
  Thirty-one male patients with advanced HF, scheduled for implantation of a CRT device, were included in the study. Left ventricular systolic function, New York Heart Association (NYHA) class, libido, and ED were assessed before and 6 months after CRT. Libido and ED were evaluated with the Aging Male Symptoms (AMS) rating scale and internationally validated Sexual Health Inventory for Men (SHIM) questionnaire, respectively.
  
  
  RESULTS
  At the 6-month follow-up, the mean NYHA class improved from 3.4 ± 0.5 to 2.1 ± 0.6 (P<0.001). On echocardiographic examination, an improvement in left ventricular ejection fraction (LVEF) from 18 ± 5% to 32 ± 6% was detected (P<0.001). A significant increase in mean SHIM score and a significant decrease in mean AMS were noted. Changes in SHIM and AMS scores were correlated positively with the increase in LVEF (r = 0.47, P = 0.007 and r = - 0.36, P = 0.04, respectively). Similarly, SHIM scores were correlated negatively (r = - 0.57, P = 0.001) and AMS scores were correlated positively (r = 0.73, P = 0.0001) with the improvement in NYHA class.
  
  
  CONCLUSIONS
  CRT results in a significant improvement in libido and erectile function in patients with congestive HF. This improvement is related to the improvements in the LVEF and functional capacity. .
authors.affiliation: Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Vural
authors.forename: Aysen
authors.initials: A
authors.lastname: Agacdiken
authors.forename: Umut
authors.initials: U
authors.lastname: Celikyurt
authors.forename: Melih
authors.initials: M
authors.lastname: Culha
authors.forename: Goksel
authors.initials: G
authors.lastname: Kahraman
authors.forename: Guliz
authors.initials: G
authors.lastname: Kozdag
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
mesh_terms: D058406:Cardiac Resynchronization Therapy; D002908:Chronic Disease; D007172:Erectile Dysfunction / Q000209:etiology* / Q000503:physiopathology; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007989:Libido; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D014463:Ultrasonography; D016277:Ventricular Function, Left