陰莖動脈收縮期最高流速可能預期勃起障礙患者罹患心血管疾病之風險
謝宜珈、林于巧、林宗彥、詹皓程、歐穎謙，林信男，林永明、鄭裕生
國立成功大學醫學院附設醫院泌尿部
Yi-Chia Hsieh, Yu-Chiao Lin, Tsung-Yen Lin, Hau-Chern Jan, Ying-Chien Ou, Shinn-Nan Lin, Yung-Ming Lin, Yu-Sheng Cheng
Department of Urology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
Purpose:
Since atherosclerosis could be formed in small arteries and subsequently result in vessel stenosis, we hypothesized that the penile doppler parameters might be a potential window to cardiovascular disease. Therefore, this study investigates the association between penile doppler parameters and cardiovascular disease in men with erectile dysfunction.
Materials and Methods:
This retrospective study included patients with erectile dysfunction from 2016 to 2022 in the andrological clinic of NCKUH. Patients with a history of penile trauma or Peyronie's disease were excluded. All the patients received penile doppler ultrasound to obtain hemodynamic parameters: peak systolic velocity (PSV), end-diastolic velocity (EDV), and the resistance index (RI). The baseline characteristics and complete biochemical parameters of our patients were collected. The atherogenic index of plasma (AIP) were also calculated. The association between penile doppler parameters and cardiovascular disease was analyzed with Chi-Square Test, t-test, and logistic regression. P-value <0.05 was set to be significance.
Results:
A total of 960 patients was enrolled in this study and then classified into three groups according to penile Doppler parameters. That is, 448 patients (46.7%) with normal penile doppler findings were in non-vascular ED group, 226 patients (23.5%) with arterial insufficiency were in AI group, and 286 (29.8%) patients with venous occlusive disease were in VOD group. Moreover, in patients with non-vascular ED, the higher the PSV level, the lower risk of coronary artery disease. On the other hand, patients diagnosed with unilateral AI have a significantly higher proportion of coronary artery disease and higher AIP levels than patients with the non-vascular disease. Besides, patients with bilateral AI have a substantially higher proportion of coronary artery disease and higher AIP levels than patients with unilateral AI.
Conclusions:
Our result indicates that peak systolic velocity level of penile doppler might indicate the risk of cardiovascular disease in patients with erectile dysfunction, including non-vascular ED patient or patient with arterial insufficiency.