Screening of ischemic heart disease with cavernous artery blood flow in erectile dysfunctional patients

Erection is a hemodynamic event and accordingly, erectile dysfunction (ED) is closely related with ischemic heart disease. We should confirm that the cardiac condition of the ED patient is safe enough to perform sexual interc ourse prior to beginning treatment for ED. Asymptomatic ischemic heart dise ase cannot be diagnosed only in an interview, but it's difficult to perform cardiac exercise tests on all patients complaining of ED. Therefore, scree ning methods to evaluate patients who should undergo exercise tests are nee ded. Sixty patients with erectile dysfunction participated in this study, p hysical examinations, interviews, and color Doppler examinations were condu cted. Chest X-rays and electrocardiograms of all patients in the resting po sition were obtained, as were electrocardiograms following exercise. Echoca rdiograms, treadmill test results, thallium exercise scintigrams, and coron ary angiograms were obtained as required for diagnosis. Two patients were e xcluded because they had obvious arteriogenic ED due to perineal injury. Fi fty-eight patients underwent Doppler evaluations of their cavernous arterie s and heart exercise tests, Fourteen patients (24.1%) were diagnosed with i schemic heart disease. Although six of them had already been diagnosed with ischemic heart disease, eight were newly diagnosed by the exercise tests. Cardiovascular risk factors such as advanced age, hyperlipidemia, diabetes mellitus, hypertension, smoking, and obesity were not sufficient predictive factors. The mean peak systolic velocity of the patients without ischemic heart disease was 34.6 cm/s vs 22.0 cm/s in those with ischemic heart disea se. Only 3.7% of patients whose peak systolic velocity in the cavernous art ery was equal to or exceeded 35 cm/s had ischemic heart disease, On the oth er hand, 41.9% of patients with peak systolic velocity of less than 35 cm/s had ischemic heart disease. The sensitivity of peak systolic velocity agai nst ischemic heart disease was 92.9%, and specificity was 59.1%. In ED pati ents, incidences of complications involving symptomatic or asymptomatic isc hemic heart disease were found to be high. The peak systolic velocity in th e cavernous artery is thought to be a useful predictive factor of ischemic heart disease in ED patients, When a patient reveals a peak systolic veloci ty of less than 35 cm/s, he should undergo heart exercise tests prior to tr eatment of ED.