Baumhäkel M, Böhm M
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, D-66421 Homburg/Saar, Germany.
Int J Clin Pract. 2007 Mar;61(3):361-6. doi: 10.1111/j.1742-1241.2006.01274.x.
Erectile dysfunction (ED) is related to cardiovascular risk factors by an impairment of endothelial function. Therefore, symptoms of ED are probably to precede cardiovascular disease and events. Moreover, endothelial dysfunction is common in patients with decreased left ventricular ejection fraction (LVEF). Hence, left ventricular dysfunction probably results in a decreased erectile function. A total of 192 cardiovascular high-risk patients from the EROSS Programme (Evaluation of Role of Sexual Dysfunction in the Saarland Programme) were evaluated regarding onset and severity of ED using the IIEF-5 questionnaire. LVEF was measured with magnetic resonance imaging, angiographically or echocardiographically. Prevalence of ED was 80.6%. Patients with moderate or severe impairment of ejection fraction had a significant increase of ED (p = 0.001). Multivariate analysis identified LV dysfunction as an independent risk factor for ED independent of heart failure symptoms (p = 0.001). Moreover, symptoms of ED appeared 3.04 +/- 7.2 years prior to the cardiovascular event (p = 0.005). LVEF is an independent risk factor for the development or increase of ED in cardiovascular high-risk patients, probably caused by an impairment of endothelial function. Hence, ED is suggested to be an early symptom of generalised cardiovascular disease and events. Thus, cardiovascular evaluation is recommended in patients with ED providing the opportunity of optimised preventional treatment.
勃起功能障碍（ED）与心血管危险因素相关，其机制是内皮功能受损。因此，ED症状可能先于心血管疾病及事件出现。此外，左心室射血分数（LVEF）降低的患者中内皮功能障碍很常见。因此，左心室功能障碍可能导致勃起功能下降。来自EROSS项目（萨尔州项目中性功能障碍作用的评估）的192例心血管高危患者使用IIEF-5问卷对ED的发病情况和严重程度进行了评估。LVEF通过磁共振成像、血管造影或超声心动图进行测量。ED的患病率为80.6%。射血分数中度或重度受损的患者ED显著增加（p = 0.001）。多变量分析确定左心室功能障碍是ED的独立危险因素，与心力衰竭症状无关（p = 0.001）。此外，ED症状在心血管事件之前3.04±7.2年出现（p = 0.005）。LVEF是心血管高危患者发生或加重ED的独立危险因素，可能是由内皮功能受损所致。因此，ED被认为是全身性心血管疾病及事件的早期症状。因此，建议对ED患者进行心血管评估，以便有机会进行优化的预防性治疗。
