Erectile dysfunction: relationship between penile hemodynamics and left ventricular diastolic function

Introduction. Erectile dysfunction (ED) is one of the most common male urological complaints. At the same time, ED is pathogenetically closely associated with many life-threatening diseases (coronary heart disease, cerebrovascular diseases). Purpose. Based on Doppler data, determine the relationship between the blood flow in the cavernous arteries and intracardiac hemodynamics. Materials and methods. There are 246 men aged 40-65years with complaints of erectile dysfunction was evaluated. The examination included anthropometry, questionnaires (IIEF-5, AMS), biochemical, hormonal blood tests and a comprehensive instrumental study: (Penile Doppler ultrasound, Holter ECG monitoring, Treadmill test, EchoCG). Results. Patients with arteriogenic ED have a significantly different risk factor profile. These patients have worse indicators of intracardiac hemodynamics compared to ED of other etiology - a higher ratio of the maximum rate of early and late left ventricular filling (E/A), lower rates of slowing down of early diastolic left ventricular filling and the time of isovolumic relaxation of the left ventricle. A significant correlation was found between the peak systolic blood flow velocity in the cavernous bodies of the penis, the resistance index in the cavernous arteries, and the E/A ratio. Discussion. Arteriogenic ED may be a sign of left ventricular diastolic myocardial dysfunction in men without symptoms of cardiovascular disease and may be a criterion for the formation of a group of high cardiovascular risk. Changes in left ventricular diastolic filling appear in most heart diseases earlier than LV systolic dysfunction. Therefore, the identification of diastolic dysfunction of the left ventricular myocardium in men without symptoms of cardiovascular disease can be a selection criterion for more invasive research methods (for example, coronary angiography). Conclusions. Penile hemodynamics can be used as a predictive marker for early forms of cardiovascular disease.