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Carotid artery intima-media thickness can predict the response of patients with erectile dysfunction to phosphodiesterase 5 inhibitors

International Journal of Impotence Research volume 31, pages 139–144 (2019)Cite this article

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Abstract

This study investigated the role of carotid artery intima-media thickness (IMT) as a morphological marker of the response of vasculogenic erectile dysfunction (ED) patients to tadalafil, one of the phosphodiesterase 5 inhibitor (PDE5-I). Through March–December 2016, 51 men with vasculogenic ED aged over 30 years were enrolled in this prospective study. Vasculogenic ED was accepted as a normal testosterone level, with penile colour Doppler ultrasonography showing arteriogenic ED, venogenic ED or mixed arteriogenic and venogenic ED. All patients underwent biochemical and hormonal blood tests, ultrasonographic evaluation of the common carotid artery (CCA) IMT and penile colour Doppler ultrasonography. On-demand tadalafil (10 mg or 20 mg in cases of a non-response to 10 mg) was administered to each patient for 2 months. ED was assessed using the short form of International Index of Erectile Function (IIEF-5) before and after the drug therapy. According to the patients’ responses to the medication, they were grouped as non-responders or responders. Thirty-one of the 51 patients responded to tadalafil. The mean CCA IMT of the non-responders and responders was 0.9 ± 0.2 mm and 0.6 ± 0.2 mm, respectively (P = 0.000). The IMT of 90% of the non-responders was >0.67 mm, whereas it was >0.67 mm in 40% of the responders. The data were analysed using the Kolmogorov–Smirnov test, Chi-square test, t-test, Mann–Whitney U test and receiver operator characteristic (ROC) curves. Measurement of CCA IMT may offer an alternative and simple method to predict the response of vasculogenic ED patients to PDE5-Is.

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References

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

    Article  Google Scholar 

  2. Giuliano FA, Leriche A, Jaudinot EO, de Gendre AS. Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology. 2004;64:1196–201.

    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;43:658–65.

    Article  CAS  Google Scholar 

  4. Mirone V, Imbimbo C, Bortolotti A, Di Cintio E, Colli E, Landoni M, et al. Cigarette smoking as risk factor for erectile dysfunction: results from an Italian epidemiological study. Eur Urol. 2002;41:294–7.

    Article  Google Scholar 

  5. Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A et al. Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol. 2006;50:595–604.

    Article  Google Scholar 

  6. Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart. 2003;89:251–3.

    Article  CAS  Google Scholar 

  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;32:454–60.

    Article  Google Scholar 

  8. 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;173:526–9.

    Article  Google Scholar 

  9. Chen SF, Yao FJ, Sun XZ, Wu RP, Huang YP, Zheng FF et al. Brachial artery flow-mediated dilatation and carotid intima-media thickness in young ED patients with insulin resistance. Int J Impot Res. 2016;28:194–9.

    Article  CAS  Google Scholar 

  10. Eardley I, Donatucci C, Corbin J, El-Meliegy A, Hatzimouratidis K, McVary K, et al. Pharmacotherapy for erectile dysfunction. J Sex Med. 2010;7:524–40.

    Article  CAS  Google Scholar 

  11. Curran M, Keating G. Tadalafil. Drugs. 2003;63:2203–12.

    Article  CAS  Google Scholar 

  12. Vickers MA, Satyanarayana R. Phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction in patients with diabetes mellitus. Int J Impot Res. 2002;14:466–71.

    Article  CAS  Google Scholar 

  13. Rosen RC. Psychogenic erectile dysfunction. Classification and management. Urol Clin North Am. 2001;28:269–78.

    Article  CAS  Google Scholar 

  14. 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;49:822–30.

    Article  CAS  Google Scholar 

  15. Golijanin D, Singer E, Davis R, Bhatt S, Seftel A, Dogra V. Doppler evaluation of erectile dysfunction—part 1. Int J Impot Res. 2007;19:37–42.

    Article  CAS  Google Scholar 

  16. Claes HI, Andrianne R, Opsomer R, Albert A, Patel S, Commers K. The HelpED study: agreement and impact of the erection hardness score on sexual function and psychosocial outcomes in men with erectile dysfunction and their partners. J Sex Med. 2012;9:2652–63.

    Article  Google Scholar 

  17. 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(1):54–61.

  18. 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 

  19. Martín-Morales A, Sanchez-Cruz JJ, et al. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina study. J Urol. 2001;166:569–74.

    Article  Google Scholar 

  20. Solomon H, Man JW, Wierzbicki AS, Jackson G. Relation of erectile dysfunction to angiographic coronary artery disease. Am J Cardiol. 2003;91:230–1.

    Article  Google Scholar 

  21. Chai SJ, Barrett-Connor E, Gamst A. Small-vessel lower extremity arterial disease and erectile dysfunction: the Rancho Bernardo study. Atherosclerosis. 2009;203:620–5.

    Article  CAS  Google Scholar 

  22. Bener A, AOAA Al-Hamaq, Kamran, Al-Ansari A. Prevalence of erectile dysfunction in male stroke patients, and associated co-morbidities and risk factors. Int Urol Nephrol. 2008;40:701–8.

    Article  Google Scholar 

  23. Foresta C, Palego P, Schipilliti M, Selice R, Ferlin A, Caretta N. Asymmetric development of peripheral atherosclerosis in patients with erectile dysfunction: an ultrasonographic study. Atherosclerosis. 2008;197:889–95.

    Article  CAS  Google Scholar 

  24. Chambless LE, Folsom AR, Davis V, et al. 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 

  25. Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo AB et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med. 2000;30:328–38.

    Article  CAS  Google Scholar 

  26. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med. 1998;338:1397–404.

    Article  CAS  Google Scholar 

  27. Moreland RB, Goldstein I, Traish A. Sildenafil, a novel inhibitor of phosphodiesterase type 5 in human corpus cavernosum smooth muscle cells. Life Sci. 1998;62(PL):309–18.

    Google Scholar 

  28. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Sildenafil Study Group. Oral sildenafil in the treatment of erectile dysfunction. J Urol. 2002;167:1197.

    Article  Google Scholar 

  29. Curran M, Keating G. Tadalafil—Drugs. 2003;63: 220–312.

  30. Fonseca V, Seftel A, Denne J, Fredlund P. Impact of diabetes mellitus on the severity of erectile dysfunction and response to treatment: analysis of data from tadalafil clinical trials. Diabetologia. 2004;47:1914–23.

    Article  CAS  Google Scholar 

  31. Gamidov SI, Mazo EB, Ovchinnikov RI, Andranovich SV, Iremashvili VV. Prediction of clinical efficacy of levitra (vardenafil) in patients with arteriogenic erectile dysfunction. Urologia. 2006;4:44–9.

  32. Shefi S, Zwecker M, Pinthus JH, Mor Y, Zeilig G, Shemesh Y, et al. Bulbocavernosus reflex testing: a preliminary study on the prognostic factors for potency and response to sildenafil citrate after bilateral nerve-sparing radical prostatectomy. Int Urol Nephrol. 2010;42:39–45.

    Article  Google Scholar 

  33. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson Jr SK. Carotidartery 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  Google Scholar 

  34. Liu L, Zhao F, Yang Y, Qi LT, Zhang BW, Chen F, et al. The clinical significance of carotid intima-media thickness in cardiovascular diseases: a survey in Beijing. J Hum Hypertens. 2008;22:259–65.

    Article  Google Scholar 

  35. Caretta N, Palego P, Ferlin A, Garolla A, Bettella A, Selice R, et al. Resumption of spontaneous erections in selected patients affected by erectile dysfunction and various degrees of carotid wall alteration: role of tadalafil. Eur Urol. 2005;48:326-31–331-2.

    Article  Google Scholar 

  36. 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;45:1980–6.

    Article  Google Scholar 

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Acknowledgements

Any kind of financial support had no role in study design, data collection, data analysis, data interpretation or writing the report.

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Authors and Affiliations

  1. Harran University Faculty of Medicine, Department of Urology, Sanliurfa, Turkey

    Eyyup Sabri Pelit, Bülent Kati, İsmail Yağmur, Erkan Arslan, Adem Tunçtekin, Halil Çiftçi & Ercan Yeni

  2. Harran University Faculty of Medicine, Department of Radiology, Sanliurfa, Turkey

    Dilek Şen Dokumacı & Atakan Kırteke

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  1. Eyyup Sabri Pelit
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Pelit, E.S., Dokumacı, D.Ş., Kati, B. et al. Carotid artery intima-media thickness can predict the response of patients with erectile dysfunction to phosphodiesterase 5 inhibitors. Int J Impot Res 31, 139–144 (2019). https://doi.org/10.1038/s41443-018-0103-x

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