Yannas Dimitri, Frizza Francesca, Vignozzi Linda, Corona Giovanni, Maggi Mario, Rastrelli Giulia
Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50121-50145 Florence, Italy.
Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy.
J Clin Med. 2021 May 20;10(10):2221. doi: 10.3390/jcm10102221.
Erectile dysfunction (ED) is an early manifestation of cardiovascular (CV) disease. For this reason, men with ED should be carefully assessed for CV risk factors in order to prevent future major adverse CV events (MACE). Traditional risk factors are not found in all subjects at high CV risk. In fact, a relevant proportion of MACE occurs in men who are apparently risk factor free. In men with ED, it is important to take into account not only traditional risk factors but also unconventional ones. Several parameters that derive from good clinical assessment of subjects with ED have proven to be valuable predictors of MACE. These include family history of cardiometabolic events, alcohol abuse, fatherhood, decreased partner's sexual interest, severe impairment in erection during intercourse or during masturbation, impaired fasting glucose, increased triglycerides, obesity even without metabolic complications, decreased penile blood flows or impaired response to an intra-cavernosal injection test. Recognizing these risk factors may help in identifying, among subjects with ED, those who merit stricter lifestyle or pharmacological interventions to minimize their CV risk. Effective correction of risk factors in ED men considered as high risk, besides reducing CV risk, is also able to improve erectile function.
勃起功能障碍（ED）是心血管（CV）疾病的早期表现。因此，应对患有ED的男性进行心血管危险因素的仔细评估，以预防未来的重大不良心血管事件（MACE）。并非所有心血管高风险受试者都存在传统危险因素。事实上，相当一部分MACE发生在看似无危险因素的男性中。对于患有ED的男性，不仅要考虑传统危险因素，还要考虑非传统危险因素。对患有ED的受试者进行良好的临床评估得出的几个参数已被证明是MACE的有价值预测指标。这些因素包括心脏代谢事件家族史、酗酒、生育情况、伴侣性兴趣降低、性交或手淫时勃起严重受损、空腹血糖受损、甘油三酯升高、即使无代谢并发症的肥胖、阴茎血流减少或海绵体内注射试验反应受损。识别这些危险因素可能有助于在患有ED的受试者中确定那些需要更严格的生活方式或药物干预以将其心血管风险降至最低的人。有效纠正被视为高危的ED男性的危险因素，除了降低心血管风险外,还能够改善勃起功能。
