Erectile dysfunction (ED) is a condition with multifactorial pathogenesis, quite common among men, especially those above 60 years old. A vascular etiology is the most common cause. The interaction between chronic inflammation, androgens, and cardiovascular risk factors determines macroscopically invisible alterations such as endothelial dysfunction and subsequent atherosclerosis and flow-limiting stenosis that affects both penile and coronary arteries. Thus, ED and cardiovascular disease (CVD) should be considered two different manifestations of the same systemic disorder, with a shared aetiological factor being endothelial dysfunction. Moreover, the penile arteries have a smaller size compared with coronary arteries; thus, for the same level of arteriopathy, a more significant blood flow reduction will occur in erectile tissue compared with coronary circulation. As a result, ED often precedes CVD by 2-5 years, and its diagnosis offers a time window for cardiovascular risk mitigation. Growing evidence suggests, in fact, that patients presenting with ED should be investigated for CVD even if they have no symptoms. Early detection could facilitate prompt intervention and a reduction in long-term complications. In this review, we provide an overview of the pathogenetic mechanisms behind arteriogenic ED and CVD, focusing on the role of endothelial dysfunction as the common denominator of the two disorders. Developed algorithms that may help identify those patients complaining of ED who should undergo detailed cardiologic assessment and receive intensive treatment for risk factors are also analyzed.

Endothelial dysfunction, erectile deficit and cardiovascular disease. An overview of the pathogenetic links / De Leonardis, Federico; Colalillo, Gaia; Finazzi Agrò, Enrico; Miano, Roberto; Fuschi, Andrea; Asimakopoulos, Anastasios D. - In: BIOMEDICINES. - ISSN 2227-9059. - 10:8(2022). [10.3390/biomedicines10081848]

Endothelial dysfunction, erectile deficit and cardiovascular disease. An overview of the pathogenetic links

Fuschi, Andrea;
2022

Abstract

Erectile dysfunction (ED) is a condition with multifactorial pathogenesis, quite common among men, especially those above 60 years old. A vascular etiology is the most common cause. The interaction between chronic inflammation, androgens, and cardiovascular risk factors determines macroscopically invisible alterations such as endothelial dysfunction and subsequent atherosclerosis and flow-limiting stenosis that affects both penile and coronary arteries. Thus, ED and cardiovascular disease (CVD) should be considered two different manifestations of the same systemic disorder, with a shared aetiological factor being endothelial dysfunction. Moreover, the penile arteries have a smaller size compared with coronary arteries; thus, for the same level of arteriopathy, a more significant blood flow reduction will occur in erectile tissue compared with coronary circulation. As a result, ED often precedes CVD by 2-5 years, and its diagnosis offers a time window for cardiovascular risk mitigation. Growing evidence suggests, in fact, that patients presenting with ED should be investigated for CVD even if they have no symptoms. Early detection could facilitate prompt intervention and a reduction in long-term complications. In this review, we provide an overview of the pathogenetic mechanisms behind arteriogenic ED and CVD, focusing on the role of endothelial dysfunction as the common denominator of the two disorders. Developed algorithms that may help identify those patients complaining of ED who should undergo detailed cardiologic assessment and receive intensive treatment for risk factors are also analyzed.
2022
cardiovascular diseases; coronary artery disease; endothelial dysfunction; erectile dysfunction
01 Pubblicazione su rivista::01a Articolo in rivista
Endothelial dysfunction, erectile deficit and cardiovascular disease. An overview of the pathogenetic links / De Leonardis, Federico; Colalillo, Gaia; Finazzi Agrò, Enrico; Miano, Roberto; Fuschi, Andrea; Asimakopoulos, Anastasios D. - In: BIOMEDICINES. - ISSN 2227-9059. - 10:8(2022). [10.3390/biomedicines10081848]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1681563
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