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Erectile Dysfunction in Coronary Artery Disease and Heart Failure

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Erectile Dysfunction in Hypertension and Cardiovascular Disease

Abstract

Erectile dysfunction (ED) is a pathological condition that shares many risk factors with coronary artery disease (CAD). The links between these disorders reside in several pathophysiological mechanisms, such as endothelial dysfunction, low androgen levels, and chronic inflammation. These mechanisms would ultimately affect both the penile and coronary circulations, resulting in an increased risk of ED and CAD. Since the size of penile arteries is smaller compared to that of coronary arteries, the same level of endothelial dysfunction and atherosclerosis may lead to a more significant reduction of blood flow in erectile tissues compared to that in coronary arteries. Consequently, ED could be considered as an indicator of systemic endothelial dysfunction. Similarly, ED is a highly prevalent condition in patients with heart failure (HF), where up to 90 % of them experience some form of sexual dysfunction. Endothelial dysfunction, psychological factors, and the administration of cardiovascular drugs may be the links between ED and HF. Although sexual activity is not contraindicated in these patients, men with HF should receive detailed cardiologic assessment before having sexual intercourse. In patients at low risk of subsequent cardiovascular events, sexual activity might be beneficial in terms of improving cardiac function. Additionally, the administration of phosphodiesterase type-5 inhibitors for the treatment of ED might counteract endothelial dysfunction; decrease fibrosis, apoptosis, and hypertrophy; and improve myocardial contractility while preventing cardiovascular remodeling.

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Authors and Affiliations

  1. Department of Oncology, Unit of Urology, IRCCS San Raffaele Hospital, Via Olgettina 58, Milan, 20132, Italy

    Giorgio Gandaglia

  2. Division of Oncology/Unit of Urology; URI, IRCCS Ospedale San Raffaele, Milan, Italy

    Giorgio Gandaglia, Alberto Briganti & Francesco Montorsi

  3. Centro Cardiologico Monzino, Institute of Cardiology, University of Milan, Milan, 20132, Italy

    Piero Montorsi

  4. 1st Department of Cardiology, Athens Medical School, Profiti Elia 24, Athens, 14575, Greece

    Charalambos Vlachopoulos

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  1. Giorgio Gandaglia
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  2. Alberto Briganti
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  3. Piero Montorsi
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  4. Francesco Montorsi
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  5. Charalambos Vlachopoulos
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Correspondence to Giorgio Gandaglia .

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Editors and Affiliations

  1. Tallinn University of Technology, North Estonia Medical Centre, Tallinn, Estonia

    Margus Viigimaa

  2. Athens Medical School, Athens, Greece

    Charalambos Vlachopoulos

  3. Internal Medicine, Aristotle University, Thessaloniki, Greece

    Michael Doumas

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Gandaglia, G., Briganti, A., Montorsi, P., Montorsi, F., Vlachopoulos, C. (2015). Erectile Dysfunction in Coronary Artery Disease and Heart Failure. In: Viigimaa, M., Vlachopoulos, C., Doumas, M. (eds) Erectile Dysfunction in Hypertension and Cardiovascular Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-08272-1_7

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