Vicenzini Edoardo, Altieri Marta, Michetti Paolo Maria, Ricciardi Maria Chiara, Ciccariello Mauro, Shahabadi Hossein, Puccinelli Francesco, Lenzi Gian Luigi, Di Piero Vittorio
Department of Neurological Sciences, University of Rome, La Sapienza, Rome, Italy.
Eur Neurol. 2008;60(2):85-8. doi: 10.1159/000136653. Epub 2008 Jun 5.
Erectile dysfunction (ED) is not only evidence of diffuse atherosclerosis but also an index of early endothelial damage. We investigated cerebrovascular reactivity, expression of early arterial damage, in patients with isolated ED (ED+) and controls (ED-).
Fifteen ED+ and 15 ED- subjects, matched for age (ED+: 58+/-6, ED-: 59 +/- 4 years) and vascular risk factors, were submitted to carotid duplex ultrasound and transcranial Doppler. Cerebrovascular reactivity was assessed on both middle cerebral arteries simultaneously calculating (a) the total vasomotor range (VMR) measured after breath holding and hyperventilation and (b) the rate of change (VMR/CO(2)) after breath holding.
Carotid Duplex scanning showed a light carotid stenosis only in 3 (2 in the ED+ and 1 in the ED- group). No differences were observed in intima-media thickness between ED+ and ED-. Slightly slower mean middle cerebral artery flow velocities were observed in ED+ with respect to ED-. ED+ patients showed a reduced VMR (p < 0.001) and a slower VMR/CO(2) rate of change (p < 0.001) compared to ED-.
The reduced reactivity in patients with isolated ED may represent a marker of early cerebral vasomotor dysfunction due to subclinical endothelial damage.
勃起功能障碍（ED）不仅是弥漫性动脉粥样硬化的证据，也是早期内皮损伤的指标。我们研究了孤立性勃起功能障碍患者（ED+）和对照组（ED-）的脑血管反应性，即早期动脉损伤的表达情况。
15名ED+患者和15名ED-患者，年龄匹配（ED+：58±6岁，ED-：59±4岁）且血管危险因素匹配，接受了颈动脉双功超声和经颅多普勒检查。同时对双侧大脑中动脉的脑血管反应性进行评估，计算（a）屏气和过度通气后测量的总血管舒缩范围（VMR），以及（b）屏气后的变化率（VMR/CO₂）。
颈动脉双功扫描仅在3例患者中显示轻度颈动脉狭窄（ED+组2例，ED-组1例）。ED+组和ED-组在内膜中层厚度上未观察到差异。与ED-组相比，ED+组大脑中动脉平均血流速度略慢。与ED-组相比，ED+患者的VMR降低（p<0.001），VMR/CO₂变化率较慢（p<0.001）。
孤立性ED患者反应性降低可能代表由于亚临床内皮损伤导致的早期脑血管舒缩功能障碍的标志物。
