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Evaluation of arterial stiffness and cardiac function in patients with vascular erectile dysfunction: acute effects of phosphodiesterase-5 inhibitor tadalafil


This study aimed to detect endothelial dysfunction in erectile dysfunction (ED) patients free from cardiovascular diseases or atherosclerotic risk factors and to evaluate acute effects of phosphodiesterase-5 inhibitor tadalafil on endothelial dysfunction and cardiac function. Thirty ED patients and 20 healthy male subjects (mean ages: 48.7±11.7 and 48.3±8.7 years, respectively) were enrolled. Endothelium functions were assessed by applanation tonometry. Aortic stiffness and cardiac function were evaluated by transthoracic echocardiography. Pulse pressure was greater in the ED group (P<0.05), whereas aortic strain and aortic distensibility were significantly lower (P<0.001). Treatment with tadalafil reduced pulse pressure (P=0.0179), systolic blood pressure (P=0.001) and diastolic blood pressure (P=0.054) and increased aortic distensibility (P=0.001) and aortic strain (P=0.003) in the ED group. Tadalafil administration also increased large artery and small artery elasticity indices that were reduced in the ED group at baseline (P=0.02 and 0.003, respectively). Systemic vascular disease and compromised left ventricular diastolic function (LVDF) were present in ED patients with no known atherosclerotic risk factors and cardiac diseases. Tadalafil positively affected arterial stiffness and LVDF.

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  1. 1

    NIH Consensus Conference. Impotence: NIH consensus development panel on impotence. JAMA 1993; 270: 83–90.

    Article  Google Scholar 

  2. 2

    McKinlay JB . The worldwide prevalence and epidemiology of erectile dysfunction. Int J Impot Res 2000; 12: 6–11.

    Article  Google Scholar 

  3. 3

    Lue TF . Erectile dysfunction. N Engl J Med 2000; 342: 1802–1813.

    CAS  Article  Google Scholar 

  4. 4

    Bortolotti A, Parazzini F, Colli E, Landoni M . The epidemiology of erectile dysfunction and its risk factors. Int J Androl 1997; 20: 323–334.

    CAS  Article  Google Scholar 

  5. 5

    Azadzoi KM, Goldstein I . Erectile dysfunction due to atherosclerotic vascular disease: the development of a animal model. J Urol 1992; 147: 1675–1681.

    CAS  Article  Google Scholar 

  6. 6

    Paulus WJ, Vantrimpton PJ, Shah AM . Paracrine coronary endothelial control of left ventricular function in humans. Circulation 1995; 92: 2119–2126.

    CAS  Article  Google Scholar 

  7. 7

    van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001; 32: 454–460.

    CAS  Article  Google Scholar 

  8. 8

    Stefanadis C, Dernellis J, Toutouzas P . Mechanical properties of the aorta determined by the pressure-diameter relation. Pathol Biol (Paris) 1999; 47: 696–704.

    CAS  Google Scholar 

  9. 9

    Wilkinson IB, Qasem A, McEniery CM, Webb DJ, Avolio AP, Cockcroft JR . Nitric oxide regulates local arterial distensibility in vivo. Circulation 2002; 105: 213–217.

    CAS  Article  Google Scholar 

  10. 10

    Vlachopoulos C, Ioakeimidis N, Aznaouridis K, Terentes-Printzios D, Rokkas K, Aggelis A et al. Prediction of cardiovascular events with aortic stiffness in patients with erectile dysfunction. Hypertension 2014; 64: 672–678.

    CAS  Article  Google Scholar 

  11. 11

    Kawanishi Y, Lee KS, Kimura K, Koizumi T, Nakatsuji H, Kojima K et al. Screening of ischemic heart disease with cavernous artery blood flow in erectile dysfunctional patients. J Impot Res 2001; 13: 100–103.

    CAS  Article  Google Scholar 

  12. 12

    Kim SW, Paick J, Park DW, Chae I, Oh B . Potential predictors of asymptomatic ischemic heart disease in patients with vasculogenic erectile dysfunction. Urology 2001; 58: 441–445.

    CAS  Article  Google Scholar 

  13. 13

    Hatzichristou D, Hatzimouratidis K, Bekas M, Apostolidis A, Tzortzis V, Yannakoyorgos K . Diagnostic steps in the evaluation of patients with erectile dysfunction. J Urol 2002; 168: 615–620.

    Article  Google Scholar 

  14. 14

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

    Article  Google Scholar 

  15. 15

    Uslu N, Eren M, Gorgulu S, Alper AT, Orhan AL, Yildirim A et al. Left ventricular diastolic function and endothelial function in patients with erectile dysfunction. Am J Cardiol 2006; 97: 1785–1788.

    CAS  Article  Google Scholar 

  16. 16

    Duprez DA, De Buyzere ML, De Backer TL, Clement DL, Cohn JN . Relationship between arterial elasticity indices and carotid arterial elasticity intima–media thickness. Am J Hypertens 2000; 13: 1226–1232.

    CAS  Article  Google Scholar 

  17. 17

    Duprez DA, Kaiser DR, Whitwam W, Finkelstein S, Belalcazar A, Patterson R et al. Determinants of radial artery pulse wave analysis in asymptomatic individuals. Am J Hypertens 2004; 17: 647–653.

    Article  Google Scholar 

  18. 18

    Oztürk S, Baltacı D, Ayhan SS, Durmuş I, Gedikli O, Soytürk M et al. Assessment of the relationship between aortic pulse wave velocity and aortic arch calcification. Turk Kardiyol Dern Ars 2012; 40: 683–689.

    Article  Google Scholar 

  19. 19

    Toutouzas K, Stefanadis C, Tsiamis E, Vlachopoulos C, Tousoulis D, Tsioufis C et al. Aortic pressure-diameter relation in patients with non-insulin dependent diabetes mellitus: new insights. Diabetologia 2000; 43: 1070–1075.

    CAS  Article  Google Scholar 

  20. 20

    Shigemura K, Arakawa S, Kamidono S, Nakano Y, Fujisawa M . Effect of sildenafil on arterial stiffness, as assessed by pulse wave velocity, in patients with erectile dysfunction. Int J Urol 2006; 13: 956–959.

    CAS  Article  Google Scholar 

  21. 21

    Stuckey BG, Walsh JP, Ching HL, Stuckey AW, Palmer NR, Thompson PL et al. Erectile dysfunction predicts generalised cardiovascular disease: evidence from a case-control study. Atherosclerosis 2007; 194: 458–464.

    CAS  Article  Google Scholar 

  22. 22

    Bellotto F, Ruscazio M, Bonanni G, Montisci R, Cutolo A, Sarais C et al. Immediate and late-hemodynamic coronary effects of tadalafil in men with erectile dysfunction and coronary artery disease. Int J Impot Res 2008; 20: 168–172.

    CAS  Article  Google Scholar 

  23. 23

    Cecelja M, Chowienczyk P . Role of arterial stiffness in cardiovascular disease. JRSM Cardiovasc Dis 2012; 31: 1–11.

    Google Scholar 

  24. 24

    Stewart AD, Jiang B, Millasseau SC, Ritter JM, Chowienczyk PJ . Acute reduction of blood pressure by nitroglycerin does not normalize large artery stiffness in essential hypertension. Hypertension 2006; 48: 404–410.

    CAS  Article  Google Scholar 

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Correspondence to S Güllülü.

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Özdabakoğlu, O., Güllülü, S., Sağ, S. et al. Evaluation of arterial stiffness and cardiac function in patients with vascular erectile dysfunction: acute effects of phosphodiesterase-5 inhibitor tadalafil. Int J Impot Res 29, 96–100 (2017).

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