Erectile Dysfunction as a Marker of Subclinical Biventricular Diastolic Dysfunction: A Prospective Echocardiographic Study-Uncorrected Proof

OBJECTIVE
Erectile dysfunction (ED) and cardiovascular disease share similar vascular pathologies, particularly endothelial dysfunction and atherosclerosis. Increasing evidence indicates that ED may serve as an early signal of underlying cardiac abnormalities, particularly diastolic dysfunction (DD), even in the absence of clinical cardiovascular disease.

METHOD
This prospective, single-center study involved 87 patients with ED, matched with 53 healthy controls based on age and body mass index. The severity of ED was evaluated using the International Index of Erectile Function (IIEF), categorizing patients into mild, moderate, and severe ED. The DD was assessed according to established guidelines.

RESULTS
Patients with ED demonstrated significant impairments in left ventricular DD, characterized by reduced E/A and e′ velocities, prolonged isovolumetric relaxation time (IVRT), and left atrial (LA) enlargement. There was a correlation between increasing severity of ED and worsening right ventricular (RV) diastolic indices, specifically reduced RV e′ and elevated RV E/e′. Notably, LA enlargement and IVRT were identified as independent predictors of ED.

CONCLUSION
ED is independently linked to subclinical biventricular DD, even when overt cardiovascular disease is not present. Echocardiography may help detect subclinical cardiac dysfunction in men with ED and improve cardiovascular risk assessment.