Omland Torbjørn, Randby Anna, Hrubos-Strøm Harald, Røsjø Helge, Einvik Gunnar
Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Center for Heart Failure Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Center for Heart Failure Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Am J Cardiol. 2016 Dec 15;118(12):1821-1825. doi: 10.1016/j.amjcard.2016.08.070. Epub 2016 Sep 13.
The circulating concentration of cardiac troponin I (cTnI) is an index of subclinical myocardial injury in several patient populations and in the general population. Erectile dysfunction is associated with greater risk for cardiovascular events, but the association with subclinical myocardial injury is not known. We aimed to test the hypothesis that the presence and severity of erectile dysfunction is associated with greater concentrations of cTnI in the general population. The presence and severity of erectile dysfunction was assessed by administering the International Index of Erectile Function 5 (IIEF-5) questionnaire to 260 men aged 30 to 65 years recruited from a population-based study. Concentrations of cTnI were determined by a high-sensitivity (hs) assay. Hs-cTnI levels were significantly higher in subjects with than in those without erectile dysfunction (median 2.9 vs 1.6 ng/l; p <0.001). Men with erectile dysfunction (i.e., IIEF-5 sum score <22) were also significantly older; had a higher systolic blood pressure, lower estimated glomerular filtration rate, higher augmentation index and N-terminal pro-B-type natriuretic peptide; and had a higher prevalence of hypertension, diabetes mellitus, and previous coronary artery disease than subjects without erectile dysfunction. These covariates were adjusted for in a multivariate linear regression model, yet the IIEF-5 sum score remained significantly negatively associated with the hs-cTnI concentration (standardized β -0.206; p <0.001). In conclusion, the presence and severity of erectile dysfunction is associated with circulating concentrations of hs-cTnI, indicating subclinical myocardial injury independently of cardiovascular risk factors, endothelial dysfunction and heart failure biomarkers.
在多个患者群体及普通人群中，心肌肌钙蛋白I（cTnI）的循环浓度是亚临床心肌损伤的一个指标。勃起功能障碍与心血管事件风险增加相关，但与亚临床心肌损伤的关联尚不清楚。我们旨在检验这一假设：在普通人群中，勃起功能障碍的存在及严重程度与更高的cTnI浓度相关。通过向从一项基于人群的研究中招募的260名年龄在30至65岁的男性发放国际勃起功能指数5（IIEF-5）问卷，评估勃起功能障碍的存在及严重程度。采用高敏（hs）检测法测定cTnI浓度。有勃起功能障碍的受试者的hs-cTnI水平显著高于无勃起功能障碍者（中位数分别为2.9 ng/l和1.6 ng/l；p<0.001）。有勃起功能障碍（即IIEF-5总分<22）的男性年龄也显著更大；收缩压更高，估算肾小球滤过率更低，增强指数及N末端B型利钠肽原更高；与无勃起功能障碍的受试者相比，高血压、糖尿病及既往冠心病的患病率更高。在多变量线性回归模型中对这些协变量进行了校正，但IIEF-5总分仍与hs-cTnI浓度显著负相关（标准化β为-0.206；p<0.001）。总之，勃起功能障碍的存在及严重程度与hs-cTnI的循环浓度相关，表明存在独立于心血管危险因素、内皮功能障碍及心力衰竭生物标志物的亚临床心肌损伤。
