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The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction

International Journal of Impotence Research volume 19, pages 577–583 (2007)Cite this article

Abstract

The aim of this study was to investigate the relationship between penile color Doppler sonography (CDS) findings and sonographic endothelial parameters in patients with erectile dysfunction (ED), including intima-media thickness (IMT) of common carotid arteries (CCA) and flow-mediated dilatation (FMD) of brachial artery. Fifty-six ED patients were included in the study. Penile CDS, IMT of CCA and FMD of brachial artery were performed in all patients. According to penile CDS findings, 27 (48%) patients had non-vasculogenic and 29 (52%) patients had vasculogenic ED. Among 29 patients, 17 (30%) patients had cavernous veno-occlusive disease (CVOD) and 12 (22%) patients had arterial/combined insufficiency (AI). Median (interquartile range) FMD values of non-vasculogenic ED, CVOD and AI were 12.50 (6.54)%, 12.82 (7.41)% and 6.25 (7.17)%, respectively. FMD was found to be impaired significantly in AI group when compared to the other groups. FMD values of CVOD group were lower when compared to non-vasculogenic group, but the difference was not statistically significant. IMT values of vasculogenic ED patients were higher than non-vasculogenic ED patients (P<0.05). Although IMT values were higher in AI group when compared to CVOD, the difference was not statistically significant. The combined use of IMT and FMD established the diagnosis of vasculogenic ED with 100% sensitivity and 59.2% specificity. The positive predictive value was 72%, negative predictive value 100% and accuracy 80%. The combined use of brachial artery FMD and carotid arteries IMT measurements may be suggested as an alternative method to evaluate vasculogenic ED.

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References

  1. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  2. Dayan L, Greunwald I, Vardi Y, Jacob G . A new clinical method for the assessment of penile endothelial function using the flow mediated dilation with plethysmography technique. J Urol 2005; 173: 1268–1272.

    Article  Google Scholar 

  3. Sullivan ME, Thompson CS, Dashwood MR, Khan MA, Jeremy JY, Morgan RJ et al. Nitric oxide and penile erection: is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res 1999; 43: 658–665.

    Article  CAS  Google Scholar 

  4. Bocchio M, Scarpelli P, Necozione S, Pelliccione F, Mhialca R, Spartera C et al. Intima-media thickening of common carotid arteries is a risk factor for severe erectile dysfunction in men with vascular risk factors but no clinical evidence of atherosclerosis. J Urol 2005; 173: 526–529.

    Article  Google Scholar 

  5. Speel TG, van Langen H, Wijkstra H, Meuleman EJ . Penile duplex pharmaco-ultrasonography revisited: revalidation of the parameters of the cavernous arterial response. J Urol 2003; 169: 216–220.

    Article  CAS  Google Scholar 

  6. Hashimoto M, Eto M, Akishita M, Kozaki K, Ako J, Iijima K et al. Correlation between flow-mediated vasodilatation of the brachial artery and intima-media thickness in the carotid artery in men. Arterioscler Thromb Vasc Biol 1999; 19: 2795–2800.

    Article  CAS  Google Scholar 

  7. Kaya C, Uslu Z, Karaman I . Is endothelial function impaired in erectile dysfunction patients? Int J Impot Res 2006; 18: 55–60.

    Article  CAS  Google Scholar 

  8. Yavuzgil O, Altay B, Zoghi M, Gurgun C, Kayikcioglu M, Kultursay H . Endothelial function in patients with vasculogenic erectile dysfunction. Int J Cardiol 2005; 103: 19–26.

    Article  Google Scholar 

  9. Lue TF, Hricak H, Marich KW, Tanagho EA . Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology 1985; 155: 777–781.

    Article  CAS  Google Scholar 

  10. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A . The International Index of Erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.

    Article  CAS  Google Scholar 

  11. Secil M, Altay C, Gulcu A, Cece H, Goktay AY, Dicle O . Automated measurement of intima-media thickness of carotid arteries in ultrasonography by computer software. Diagn Interv Radiol 2005; 11: 105–108.

    PubMed  Google Scholar 

  12. Yan RT, Anderson TJ, Charbonneau F, Title L, Verma S, Lonn E . Relationship between carotid artery intima-media thickness and brachial artery flow-mediated dilation in middle-aged healthy men. J Am Coll Cardiol 2005; 45: 1980–1986.

    Article  Google Scholar 

  13. Vogel RA . Measurement of endothelial function by brachial artery flow-mediated vasodilation. Am J Cardiol 2001; 88: 31E–34E.

    Article  CAS  Google Scholar 

  14. O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson Jr SK . Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340: 14–22.

    Article  CAS  Google Scholar 

  15. Chambless LE, Folsom AR, Davis V, Sharrett R, Heiss G, Sorlie P . Risk factors for progression of common carotid atherosclerosis: the Atherosclerosis Risk in Communities Study, 1987–1998. Am J Epidemiol 2002; 155: 38–47.

    Article  Google Scholar 

  16. Smilde TJ, Wollersheim H, Van Langen H, Stalenhoef AF . Reproducibility of ultrasonographic measurements of different carotid and femoral artery segments in healthy subjects and in patients with increased intima-media thickness. Clin Sci (London) 1997; 93: 317–324.

    Article  CAS  Google Scholar 

  17. Mazo E, Gamidov S, Anranovich S, Iremashvili V . Testing endothelial function of brachial and cavernous arteries in patients with erectile dysfunction. J Sex Med 2006; 3: 323–330.

    Article  Google Scholar 

  18. Kaiser DR, Billups K, Mason C, Wetterling R, Lundberg JL, Bank AJ . Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004; 43: 179–184.

    Article  Google Scholar 

  19. Alkhayal S, Lehmann V, Thomas P . A simple noninvasive test to detect vascular disease in patients with erectile dysfunction: a novel method. J Sex Med 2006; 3: 331–336.

    Article  Google Scholar 

  20. Andersson KE . Erectile physiological and pathophysiological pathways involved in erectile dysfunction. J Urol 2003; 170: S6–S13.

    Article  Google Scholar 

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Acknowledgements

This study was supported by Dokuz Eylul University Research Fund Study no. 04.KB.SAG.070.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Inciralti, Turkey

    G Ucar & M Secil

  2. Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Inciralti, Turkey

    O Demir & A A Esen

  3. Department of Endocrinology, Faculty of Medicine, Dokuz Eylul University, Izmir, Inciralti, Turkey

    T Demir & A Comlekci

  4. Department of Biochemistry, Faculty of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey,

    S Uysal

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  1. G Ucar
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Correspondence to M Secil.

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Ucar, G., Secil, M., Demir, O. et al. The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction. Int J Impot Res 19, 577–583 (2007). https://doi.org/10.1038/sj.ijir.3901572

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  • DOI: https://doi.org/10.1038/sj.ijir.3901572

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