Abstract 3632: Aortic Stiffness and Carotid Intima Media Thickness are Associated with Penile Doppler Findings in Patients with Vasculogenic Erectile Dysfunction

Objective: Erectile dysfunction (ED) may be a sign of generalized vascular disease. Intima-media thickness (IMT) and aortic stiffness are markers and prognosticators of cardiovascular risk. The association between ED and measures of IMT and aortic stiffness has not been investigated.

Methods: A total of 95 men with ED (detected with a validated questionnaire) were studied: 36 men (62±9 yrs) with coronary artery disease (CAD) and 59 men (59±11 yrs) without CAD. Mean IMT of the common carotid arteries, carotid-femoral pulse wave velocity (PWV) as an index of aortic stiffness and pharmacologically stimulated peak systolic velocity (PSV) of cavernous arteries were used to assess vascular damage.

Results: Patients with CAD had decreased PSV (27.2 vs 33.8 cm/s, p=0.01), increased IMT (0.98 vs 0.82, p<0.001) and increased PWV (8.9 vs 8.2 m/s, p<0.01) compared with men without CAD. PSV was inversely correlated with age (r= −0.24, p<0.05), pulse pressure (r= −0.25, p<0.05), Framingham score (r= −0.28, p<0.05), IMT, PWV and high sensitivity C-reactive protein (hsCRP) (figure). After adjusting for potential confounding factors such as age, mean pressure, BMI, total cholesterol, HDL, hsCRP and intensity of smoking in multivariate linear regression models, penile PSV was independently associated with both IMT (r= −0.39, p=0.002) and PWV (r= −0.31, p=0.01) (adjusted R² of models 0.29 and 0.28 respectively).

Conclusion: Carotid IMT and aortic stiffness are associated with impaired erectile function as estimated by penile PSV. This finding provides further insights into the pathophysiology of ED and may have implications for the cardiovascular risk in these patients.