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Risk factors associated with cardiac dysfunction in men with erectile dysfunction
Emil Durukan1, Christian Fuglesang S Jensen1, Maria Dons2,3
1Department of Urology, Copenhagen University Hospital-Herlev & Gentofte, Herlev, Denmark.
Insights
Erectile dysfunction (ED) is linked to cardiac dysfunction. Key risk factors include elevated body mass index (BMI), diastolic blood pressure, hemoglobin A1c (HbA1c), and dyslipidemia, highlighting the need for cardiovascular risk assessment in men with ED.
Area of Science:
- Cardiology
- Urology
- Endocrinology
Background:
- Erectile dysfunction (ED) is an early indicator of cardiovascular disease (CVD).
- Specific clinical factors linking ED to cardiac dysfunction require clarification.
Purpose of the Study:
- To identify risk factors for cardiac dysfunction in men with ED.
- Utilize echocardiography to assess cardiac function in relation to ED.
Main Methods:
- Cross-sectional study involving men with ED recruited from urology clinics and general population samples.
- Echocardiography employed to evaluate left ventricular (LV) systolic and diastolic dysfunction.
- Analysis of associations between cardiac dysfunction and clinical variables including BMI, blood pressure, HbA1c, and lipid profiles.
Main Results:
- In multivariable analysis, elevated BMI, diastolic blood pressure, and HbA1c were significantly associated with LV systolic dysfunction.
- BMI and dyslipidemia were identified as risk factors for LV diastolic dysfunction.
- The study included 398 men, with detailed analysis of cardiometabolic risk factors.
Conclusions:
- Cardiometabolic risk factors are associated with echocardiographic evidence of cardiac dysfunction in men with ED.
- Findings underscore the importance of cardiovascular risk assessment and targeted prevention in men experiencing ED.
- Elevated BMI, diastolic blood pressure, and HbA1c are linked to LV systolic dysfunction; BMI and dyslipidemia are associated with LV diastolic dysfunction.
Background:
Erectile dysfunction (ED) is recognized as an early marker of cardiovascular disease, but the specific clinical characteristics associated with cardiac dysfunction remain unclear.
Aim:
To identify risk factors for cardiac dysfunction in men with ED as assessed with echocardiography.
Methods:
In this cross-sectional study, men with ED were recruited from a urology outpatient clinic and through invitations to randomly selected men >40 years. Echocardiography was used to assess left ventricular (LV) systolic and diastolic dysfunction.
Outcomes:
Associations between cardiac dysfunction and clinical variables-including age, body mass index (BMI), blood pressure, lipid profile, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein, and cardiovascular comorbidities-were examined.
Results:
Among 398 men, univariable analyses showed that BMI, diastolic blood pressure, and high-sensitivity C-reactive protein were associated with increased odds of LV systolic dysfunction. In multivariable analysis, BMI (OR 1.08; 95% CI: 1.01-1.15), diastolic blood pressure (OR 1.04; 95% CI: 1.01-1.07), and HbA1c (OR 1.06; 95% CI: 1.01-1.12) remained significant. For LV diastolic dysfunction, BMI (OR 1.09; 95% CI: 1.00-1.19) and dyslipidemia (OR 2.54; 95% CI: 1.11-5.72) were associated with LV diastolic dysfunction.
Clinical Implications:
These findings support the importance of cardiovascular risk assessment and targeted prevention strategies in men with ED.
Strengths And Limitations:
A key strength of this study is the large, well-characterized cohort, enabling robust analyses of risk factors for cardiac dysfunction. Its cross-sectional design, however, precludes causal inference.
Conclusion:
Cardiometabolic risk factors are associated with echocardiographic signs of cardiac dysfunction in men with ED. Elevated BMI, diastolic blood pressure, and HbA1c are linked to LV systolic dysfunction, while BMI and dyslipidemia are associated with LV diastolic dysfunction.
Clinical Trial Registration:
The study was prospectively registered at ClinicalTrials.gov (NCT05285280).
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