Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem

Rastogi, S; Rodriguez, Jennifer; Kapur, Vishal; Schwarz, Ernst R.

doi:10.1038/sj.ijir.3901426

Cited by 57 publications

(49 citation statements)

References 137 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently, before scoring ED severity, patients with hypertension should receive no medication with thiazide diuretics, central-acting sympatholytic agents, or b-blockers, even though the role of these agents in worsening ED is still controversial. 36 Besides, as the study population consists of men at a urologic clinic, there is a referral bias that might limit the overall generation of data presented. On the contrary, thinking about it in another way, this is the value of this manuscript for its being near to the real clinical practice world.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Chu

et al. 2009

Int J Impot Res

View full text Add to dashboard Cite

We determined the association between the severity of erectile dysfunction (ED) and traditional cardiovascular risk factors, including metabolic syndrome (MS). A total of 141 ED patients were divided into three groups on the basis of ED severity, which was determined using the International Index of Erectile Function (IIEF) scores. The prevalence of MS among the ED patients was 32.6%. Significantly lower IIEF scores were noted in patients with MS than in patients without MS (7.6±6.4 vs 11.6±7.4, P ¼ 0.003). As assessed by the anthropometric indices of body mass index, waist circumference and waist-to-hip ratio, obesity was detected in 58.9, 54.6 and 32.6% of the patients, respectively. Of the 141 patients, 39 had mild, 24 had moderate and 78 had severe ED. Statistically significant differences were noted among the different ED severity groups with regard to the presence of hypertension, systolic blood pressure, presence of MS and number of MS components. Multivariate analysis showed that the odds ratio for high-low-density lipoprotein (LDL) cholesterol level in moderate and severe ED, determined with reference to mild ED, were 9.346 and 6.452, respectively. The presence of MS, number of MS components, and certain traditional cardiovascular risk factors, particularly high-LDL cholesterol level and hypertension, may influence the severity of ED.

show abstract

Section: Discussionmentioning

confidence: 99%

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Chu

et al. 2009

Int J Impot Res

View full text Add to dashboard Cite

show abstract

“…Endothelial function has been shown to be altered in patients with HF (ischemic or nonischemic in nature), diabetes mellitus and CAD. 60 Some animal studies showed beneficial effects of PDE-5i use on the endothelium function in diabetics. For example, Ahn et al 61 studied the effect of DA-8159 (PDE-5i) on diabetic rats and demonstrated that chronic administration of PDE-5i attenuated the development of ED.…”

Section: Effect On the Endotheliummentioning

confidence: 99%

The effects of chronic phosphodiesterase-5 inhibitor use on different organ systems

et al. 2006

Self Cite

View full text Add to dashboard Cite

Phosphodiesterase-5 (PDE-5) inhibitors selectively inhibit PDE-5 enzymes that are present in various tissues like penile tissue, platelets, vascular, and smooth muscle tissue. The drug's actions on these tissues have lead to the successful therapeutic use in patients suffering from conditions such as erectile dysfunction (ED) and pulmonary hypertension. PDE-5 inhibitors (PDE-5i) act on the erectile tissue causing penile smooth muscle relaxation and vasodilatation leading to penile erection. In addition, in particular when used in conjunction with prostaglandin inhibitors, PDE-5i cause vasodilatation in pulmonary vasculature hence decreasing both the pulmonary arterial pressure and resistance. PDE-5i have also shown to mildly decrease blood pressure, increase cardiac index, and increase coronary blood flow in experimental animals as well as in human studies. The Food and Drug Administration (FDA) has approved three PDE-5i for the treatment of ED: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) and one for pulmonary hypertension: sildenafil (Revatio). These agents are highly selective for PDE-5 enzymes as compared to other subclasses of PDE enzymes and have the almost identical pharmacological action but slightly different pharmacokinetics. Only little data exist about long-term use of PDE-5i and their effects on different organ system. This paper reviews the current information available on chronic PDE-5 inhibitor use.

show abstract

“…7,8 ED is associated with coronary artery disease, 9 hypertension 10 and now heart failure (HF). 11 The goal of this review is to describe the prevalence of ED in HF patients, causes of ED specific to patients with HF, the cardiac risk assessment of sexual activity, the safety of PDE-5 inhibitors to treat ED in HF patients, the efficacy of PDE-5 inhibitors for ED in HF patients, the hemodynamic effects of PDE-5 inhibitors on HF, the potential mechanisms by which PDE-5 inhibitors improve HF and role of PDE-5 inhibitors in pulmonary hypertension.…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

Al-Ameri

Kloner

2009

Int J Impot Res

View full text Add to dashboard Cite

The phosphodiesterase type 5 (PDE-5) inhibitors are effective in treating erectile dysfunction (ED). ED and heart failure (HF) share similar risk factors, and commonly present together. This association has led to questions ranging from the safety and efficacy of PDE-5 inhibitors in HF patients to a possible role for this class of medication to treat HF patients with or without ED. In addition to endothelial dysfunction, there are causes of ED specific to patients with HF including low exercise tolerance, depression and HF medications. Before treating HF patients with PDE-5 inhibitors, patients should be assessed for their risk of a cardiac event during sexual activity. PDE-5 inhibitors are safe and effective in treating ED in HF patients. An improvement in erectile function by PDE-5 inhibitors was associated with an improvement in quality of life and reduction in depression. Several studies demonstrated the effect of PDE-5 inhibitors on HF per se. PDE-5 inhibitors improved endothelial dysfunction, increased exercise tolerance, decreased pulmonary vascular resistance and pulmonary artery pressure, and increased cardiac index. Several mechanisms whereby PDE-5 inhibitors improve HF have been proposed. PDE-5 inhibitors already have a role in treating primary pulmonary hypertension; however additional studies are needed to determine if they will become a standard therapy for HF patients.

show abstract

Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem

Cited by 57 publications

References 137 publications

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

The effects of chronic phosphodiesterase-5 inhibitor use on different organ systems

Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

Contact Info

Product

Resources

About