Correlation between internal pudendal artery stenosis and erectile dysfunction in patients with suspected coronary artery disease

English version

Autoři: Ha-Wook Park ^aff001; Sung-Ho Her ^aff001; Bong-Hee Park ^aff002; Dong-Seok Han ^aff002; Seung Mo Yuk ^aff002; Dae-Won Kim ^aff001; Chang Shik Youn ^aff002; Hoon Jang ^aff002
Působiště autorů: The Department of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea ^aff001; The Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea ^aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0225179

Souhrn

Background

Stenoses of internal pudendal arteries (IPAs) appear to be related to erectile dysfunction (ED). Nevertheless, the correlation between the severity of ED and stenosis of the IPAs is not well established.

Objectives

To evaluate angiographic findings of IPAs in patients with suspected coronary artery disease (CAD) and to assess the correlation between the severity of ED and IPA stenosis.

Materials and methods

Ninety-one patients who were scheduled for cardiac angiogram (CAG) because of suspected CAD participated. ED was assessed using the International Index of Erectile Function (IIEF) questionnaire. Erectile function (EF) domain scoring was used to assess the severity of ED: severe (EF score = 1–10); moderate (11–16); mild-moderate (17–21); mild (22–25); and no ED (26–30). Angiography was performed in bilateral common, internal iliac, and IPAs and the location and extent of stenoses were measured. We divided patients according to those with maximum stenosis of less than 50% (Group I) and those with more than 50% (Group II), regardless of direction.

Results

We diagnosed 88 patients (88/91, 96.70%) with ED. There was no correlation between increasing age and severity of ED (r = - 0.063, p = 0.555). There were 72 patients in Group I and 19 in Group II. In Group I, 62 patients were diagnosed with ED even though there was no stenosis. There was no significant correlation between the severity of ED and the extent of stenosis in IPAs (r = -0.118, p = 0.265).

Conclusions

There was no significant correlation between the severity of ED and the extent of stenosis of IPAs. We believe that this is because the progression of ED is induced by endothelial cell dysfunction, not by mechanical obstruction leading to blood flow reduction.

Klíčová slova:

Coronary heart disease – Angiography – Lesions – Stenosis – Arteries – Coronary arteries – Nitric oxide – Erectile dysfunction

Zdroje

1. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270(1):83–90. 8510302.

2. Meuleman EJ. Prevalence of erectile dysfunction: need for treatment? Int J Impot Res. 2002;14 Suppl 1:S22–8. doi: 10.1038/sj.ijir.3900793 11850731.

3. 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. doi: 10.1016/s0022-5347(17)34871-1 8254833.

4. McKinlay JB. The worldwide prevalence and epidemiology of erectile dysfunction. Int J Impot Res. 2000;12 Suppl 4:S6–S11. doi: 10.1038/sj.ijir.3900567 11035380.

5. Willke RJ, Yen W, Parkerson GR Jr., Linet OI, Erder MH, Glick HA. Quality of life effects of alprostadil therapy for erectile dysfunction: results of a trial in Europe and South Africa. Int J Impot Res. 1998;10(4):239–46. doi: 10.1038/sj.ijir.3900364 9884920.

6. Camacho ME, Reyes-Ortiz CA. Sexual dysfunction in the elderly: age or disease? Int J Impot Res. 2005;17 Suppl 1:S52–6. doi: 10.1038/sj.ijir.3901429 16391544.

7. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151–7. doi: 10.1016/j.amjmed.2006.06.010 17275456.

8. Sullivan ME, Keoghane SR, Miller MA. Vascular risk factors and erectile dysfunction. BJU Int. 2001;87(9):838–45. doi: 10.1046/j.1464-410x.2001.02211.x 11412223.

9. Blick C, Ritchie RW, Sullivan ME. Is Erectile Dysfunction an Example of Abnormal Endothelial Function? Curr Vasc Pharmacol. 2016;14(2):163–7. doi: 10.2174/1570161114666151202205950 26638795.

10. Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. A prospective study of risk factors for erectile dysfunction. J Urol. 2006;176(1):217–21. doi: 10.1016/S0022-5347(06)00589-1 16753404.

11. El-Sakka AI, Morsy AM, Fagih BI, Nassar AH. Coronary artery risk factors in patients with erectile dysfunction. J Urol. 2004;172(1):251–4. doi: 10.1097/01.ju.0000128572.31000.f0 15201787.

12. Chiurlia E, D'Amico R, Ratti C, Granata AR, Romagnoli R, Modena MG. Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J Am Coll Cardiol. 2005;46(8):1503–6. doi: 10.1016/j.jacc.2005.06.068 16226175.

13. Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2011;58(13):1378–85. doi: 10.1016/j.jacc.2011.06.024 21920268.

14. Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol. 2003;44(3):360–4; discussion 4–5. doi: 10.1016/s0302-2838(03)00305-1 12932937.

15. Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005;294(23):2996–3002. doi: 10.1001/jama.294.23.2996 16414947.

16. Montorsi P, Ravagnani PM, Galli S, Rotatori F, Veglia F, Briganti A, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J. 2006;27(22):2632–9. doi: 10.1093/eurheartj/ehl142 16854949.

17. Azab SS, El Din Hosni H, El Far TA, Ismail NN, El Bakdady YK, Mohamed AF. The Predictive Value of Arteriogenic Erectile Dysfunction for Coronary Artery Disease in Men. J Sex Med. 2018;15(6):880–7. doi: 10.1016/j.jsxm.2018.04.639 29759909.

18. Osondu CU, Vo B, Oni ET, Blaha MJ, Veledar E, Feldman T, et al. The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis. Vasc Med. 2018;23(1):9–20. doi: 10.1177/1358863X17725809 29243995.

19. Jackson G. Erectile dysfunction and cardiovascular disease. Arab J Urol. 2013;11(3):212–6. doi: 10.1016/j.aju.2013.03.003 26558084; PubMed Central PMCID: PMC4442980.

20. Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS, et al. Internal pudendal artery stenoses and erectile dysfunction: correlation with angiographic coronary artery disease. Catheter Cardiovasc Interv. 2010;76(6):882–7. doi: 10.1002/ccd.22646 20928837.

21. Rogers JH, Goldstein I, Kandzari DE, Kohler TS, Stinis CT, Wagner PJ, et al. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol. 2012;60(25):2618–27. doi: 10.1016/j.jacc.2012.08.1016 23177300.

22. Hossam Zaki WN, Ahmed Shawky, Ayman Mortada, Tarek Zaki. Prevalence of internal pudendal artery disease in diabetic patients with erectile dysfunction and angiographically documented multi-vessel coronary artery disease. The Egyptian Heart Jouranl. 2013;65(2):87–91. doi: 10.1016/j.ehj.2012.11.003

23. Cappelleri JC, Rosen RC, Smith MD, Mishra A, Osterloh IH. Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology. 1999;54(2):346–51. doi: 10.1016/s0090-4295(99)00099-0 10443736.

24. Mancini GB. Quantitative coronary arteriographic methods in the interventional catheterization laboratory: an update and perspective. J Am Coll Cardiol. 1991;17(6 Suppl B):23B–33B. doi: 10.1016/0735-1097(91)90935-3 2016479.

25. Kasprzak JD, Klosinska M, Drozdz J. Clinical aspects of assessment of endothelial function. Pharmacol Rep. 2006;58 Suppl:33–40. 17332669.

26. Bonetti PO, Lerman LO, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol. 2003;23(2):168–75. doi: 10.1161/01.atv.0000051384.43104.fc 12588755.

27. Mudau M, Genis A, Lochner A, Strijdom H. Endothelial dysfunction: the early predictor of atherosclerosis. Cardiovasc J Afr. 2012;23(4):222–31. doi: 10.5830/CVJA-2011-068 22614668; PubMed Central PMCID: PMC3721957.

28. Tousoulis D, Simopoulou C, Papageorgiou N, Oikonomou E, Hatzis G, Siasos G, et al. Endothelial dysfunction in conduit arteries and in microcirculation. Novel therapeutic approaches. Pharmacol Ther. 2014;144(3):253–67. doi: 10.1016/j.pharmthera.2014.06.003 24928320.

29. Park KH, Park WJ. Endothelial Dysfunction: Clinical Implications in Cardiovascular Disease and Therapeutic Approaches. J Korean Med Sci. 2015;30(9):1213–25. doi: 10.3346/jkms.2015.30.9.1213 26339159; PubMed Central PMCID: PMC4553666.

30. Woywodt A, Bahlmann FH, De Groot K, Haller H, Haubitz M. Circulating endothelial cells: life, death, detachment and repair of the endothelial cell layer. Nephrol Dial Transplant. 2002;17(10):1728–30. doi: 10.1093/ndt/17.10.1728 12270976.

31. Ganz P, Vita JA. Testing endothelial vasomotor function: nitric oxide, a multipotent molecule. Circulation. 2003;108(17):2049–53. doi: 10.1161/01.CIR.0000089507.19675.F9 14581383.

32. Ghiadoni L, Versari D, Giannarelli C, Faita F, Taddei S. Non-invasive diagnostic tools for investigating endothelial dysfunction. Curr Pharm Des. 2008;14(35):3715–22. doi: 10.2174/138161208786898761 19128224.