Department of Medicine, Section of Endocrinology and Centre for Human Reproduction Pathology, University of Padova, Padua, Italy.
CNR, Neuroscience Institute, Padua, Italy.
Andrology. 2019 Jan;7(1):82-87. doi: 10.1111/andr.12561. Epub 2018 Nov 8.
Traditional risk factors used to assess cardiovascular risk miss a significant population who are indeed at risk for future cardiac events. Erectile dysfunction (ED) is an emerging marker for future cardiovascular disease (CVD) and major adverse cardiovascular events (MACE), especially in young and middle-aged men with vasculogenic ED. Cavernous arteries morphological alterations at penile colour doppler ultrasound (P-CDU) are used to find a vasculogenic ED.
We investigated the possible relationship between cavernous arteries morphological alterations at P-CDU assessment and future MACE.
We conducted a retrospective cohort study involving 300 ED patients, aged 35-65 years (mean age 54.1 ± 7.1), with a follow-up period of 10 years. Patients underwent vascular evaluation including P-CDU, colour doppler ultrasound of the carotid and lower limbs arteries. At baseline data for glucose metabolism, lipid profile, hypertension and hormonal status were collected. During the follow-up period, the occurrence of MACE was evaluated.
We found a strong association between cavernous arteries morphological alterations and CVD with a threefold increased risk of future MACE in comparison to patients with healthy cavernous arteries (RR 3.2, 95% CI 1.17-8.78). This association remained statistically significant after adjustment for CV risk factors (age, glycaemia, total cholesterol, hypertension and smoke).
Morphological alterations of cavernous arteries are independently associated with an increased risk of future MACE. These data contribute to the formulation of the hypothesis that cavernous artery pathology at P-CDU is related to MACE.
传统的心血管风险评估因素会漏掉一部分确实存在未来心脏事件风险的人群。勃起功能障碍（ED）是未来心血管疾病（CVD）和主要不良心血管事件（MACE）的一个新兴标志物，尤其是在有血管性 ED 的年轻和中年男性中。阴茎彩色多谱勒超声（P-CDU）评估的海绵体动脉形态改变可用于发现血管性 ED。
我们研究了 P-CDU 评估的海绵体动脉形态改变与未来 MACE 之间的可能关系。
我们进行了一项回顾性队列研究，涉及 300 名年龄在 35-65 岁（平均年龄 54.1±7.1 岁）的 ED 患者，随访时间为 10 年。患者接受了血管评估，包括 P-CDU、颈动脉和下肢动脉彩色多谱勒超声。在基线数据中收集了葡萄糖代谢、血脂谱、高血压和激素状况。在随访期间，评估了 MACE 的发生情况。
我们发现海绵体动脉形态改变与 CVD 之间存在强烈关联，与海绵体动脉健康的患者相比，未来发生 MACE 的风险增加了三倍（RR 3.2，95%CI 1.17-8.78）。在调整了 CV 危险因素（年龄、血糖、总胆固醇、高血压和吸烟）后，这种关联仍然具有统计学意义。
海绵体动脉形态改变与未来 MACE 的风险增加独立相关。这些数据有助于形成假设，即 P-CDU 海绵体动脉病理学与 MACE 相关。
