From the Cardiovascular Diseases and Sexual Health Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece (C.V., N.I., K.A., D.T.-P., K.R., A.A., C.S.); and Department of Nutrition Science and Dietetics, Harokopio University, Athens, Greece (D.P.).
Hypertension. 2014 Sep;64(3):672-8. doi: 10.1161/HYPERTENSIONAHA.114.03369. Epub 2014 Jun 30.
Erectile dysfunction confers an independent risk for cardiovascular events and total mortality. Aortic pulse wave velocity (PWV) is an important predictor of cardiovascular events and all-cause mortality. We investigated whether PWV predicts major adverse cardiovascular events (MACEs) in patients with erectile dysfunction beyond traditional risk factors. MACEs in relation to PWV were analyzed with proportional hazards models in 344 patients (mean age, 56 years) without established cardiovascular disease. During a mean follow-up of 4.7 years (range, 1-8.5 years), 24 of 344 participants (7.0%) experienced a MACE. Subjects in the highest PWV tertile (>8.8 m/s) had a 4-fold higher risk of MACEs compared with those in the lowest PWV tertile (<7.6 m/s; adjusted hazard ratio, 3.97; P=0.035). A PWV value of 7.81 m/s was associated with a negative predictive value (ability to rule out MACE) of 98.1%. Addition of PWV to standard risk factor model yielded correct patient reclassification to higher or lower risk category by 27.6% (P=0.0332) in the whole cohort. Our results show that higher aortic stiffness is associated with increased risk for a MACE in patients with erectile dysfunction without known cardiovascular disease. Aortic PWV improves risk prediction when added to standard risk factors and may represent a valuable biomarker of prediction of cardiovascular disease risk in these patients.
勃起功能障碍会增加心血管事件和全因死亡率的风险。脉搏波速度（PWV）是心血管事件和全因死亡率的重要预测指标。我们研究了 PWV 是否可以预测勃起功能障碍患者的主要不良心血管事件（MACE），这些患者的传统危险因素之外。在没有确诊心血管疾病的 344 名患者（平均年龄 56 岁）中，使用比例风险模型分析了与 PWV 相关的 MACE。在平均 4.7 年（1-8.5 年）的随访期间，344 名参与者中的 24 名（7.0%）经历了 MACE。与 PWV 最低三分位组（<7.6 m/s）相比，PWV 最高三分位组（>8.8 m/s）的 MACE 风险增加了 4 倍（调整后的危险比，3.97；P=0.035）。PWV 值为 7.81 m/s 时，其阴性预测值（排除 MACE 的能力）为 98.1%。在整个队列中，将 PWV 添加到标准风险因素模型中，使 27.6%（P=0.0332）的患者得到更准确的重新分类，进入更高或更低的风险类别。我们的研究结果表明，在没有已知心血管疾病的勃起功能障碍患者中，主动脉僵硬度越高，发生 MACE 的风险就越高。当添加到标准风险因素时，PWV 可以改善风险预测，并且可能代表这些患者心血管疾病风险预测的有价值的生物标志物。
