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Xi Y, Yin X, Zhou J, Shen R, Qi L, Zhang S. Genetically predicted cardiovascular diseases could increase the risk of erectile dysfunction: a bidirectional Mendelian randomization. World J Urol 2023; 41:3187-3194. [PMID: 37782322 DOI: 10.1007/s00345-023-04630-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
PURPOSE Erectile dysfunction (ED) often appears concomitantly with cardiovascular diseases (CVDs). However, the causal relationship between ED and CVDs is still unclear. This study aimed to investigate the causal effects between CVDs and ED using bidirectional Mendelian randomization (MR). METHODS ED data (6175 cases and 217,630 controls) were obtained from the IEU OpenGWAS project. Seven types of CVDs were acquired in our study, including stroke (Sample size = 440,328), myocardial infection (Sample size = 184,305), coronary heart disease (Sample size = 86,995), hypertension (Sample size = 36,683), heart failure (Sample size = 208,178), atrial fibrillation (Sample size = 1,030,836), and coronary artery disease (Sample size = 141,217). Inverse variance weighted (IVW) was selected as the primary method for MR analysis. RESULTS IVW results indicated that stroke (OR = 1.14, 95% CI = 1.02-1.29, P = 0.025), coronary artery disease (OR = 1.09, 95% CI = 1.02-1.16, P = 0.013), coronary heart disease (OR = 1.07, 95% CI = 1.01-1.13, P = 0.017), myocardial infection (OR = 1.09, 95% CI = 1.02-1.17, P = 0.011), and atrial fibrillation (OR = 1.06, 95% CI = 1.00-1.12, P = 0.04) were causally associated with ED. The reverse MR analysis suggested that ED did not influence the prevalence of CVDs. CONCLUSION These findings highlighted CVDs as causal risk factors for ED, but ED did not directly result in the development of CVDs. Regular monitoring of the erectile function of individuals with CVDs, along with implementing appropriate preventive measures, might help reduce the incidence of ED and enhance the sexual well-being of patients with CVDs.
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Affiliation(s)
- Yujia Xi
- Department of Urology, Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, People's Republic of China
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, People's Republic of China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, People's Republic of China
| | - Xinyu Yin
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, People's Republic of China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, People's Republic of China
| | - Jing Zhou
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, People's Republic of China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, People's Republic of China
| | - Ruotong Shen
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, People's Republic of China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, People's Republic of China
| | - Likun Qi
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, People's Republic of China
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, People's Republic of China
| | - Shengxiao Zhang
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, People's Republic of China.
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, People's Republic of China.
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi Province, 030001, People's Republic of China.
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Wasilewski M, Vijayakumar A, Szigeti Z, Sathakaran S, Wang KW, Saporta A, Hitzig SL. Barriers and Facilitators to Delivering Inpatient Cardiac Rehabilitation: A Scoping Review. J Multidiscip Healthc 2023; 16:2361-2376. [PMID: 37605772 PMCID: PMC10440091 DOI: 10.2147/jmdh.s418803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Objective The purpose of this scoping review was to summarize the literature on barriers and facilitators that influence the provision and uptake of inpatient cardiac rehabilitation (ICR). Methods A literature search was conducted using PsycINFO, MEDLINE, EMBASE, CINAHL and AgeLine. Studies were included if they were published in English after the year 2000 and focused on adults who were receiving some form of ICR (eg, exercise counselling and training, education for heart-healthy living). For studies meeting inclusion criteria, descriptive data on authors, year, study design, and intervention type were extracted. Results The literature search resulted in a total of 44,331 publications, of which 229 studies met inclusion criteria. ICR programs vary drastically and often focus on promoting physical exercises and patient education. Barriers and facilitators were categorized through patient, provider and system level factors. Individual characteristics and provider knowledge and efficacy were categorized as both barriers and facilitators to ICR delivery and uptake. Team functioning, lack of resources, program coordination, and inconsistencies in evaluation acted as key barriers to ICR delivery and uptake. Key facilitators that influence ICR implementation and engagement include accreditation and professional associations and patient and family-centred practices. Conclusion ICR programs can be highly effective at improving health outcomes for those living with CVDs. Our review identified several patient, provider, and system-level considerations that act as barriers and facilitators to ICR delivery and uptake. Future research should explore how to encourage health promotion knowledge amongst ICR staff and patients.
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Affiliation(s)
- Marina Wasilewski
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Abirami Vijayakumar
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Zara Szigeti
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sahana Sathakaran
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Adam Saporta
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
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Lenasi H, Novak A, Jug B, Dervišević E, Karpljuk D, Videmšek M, Sorić M, Hadžić V. An Alternative Prediction Equation for Evaluation of Six-Minute Walk Distance in Stable Coronary Artery Disease Patients. Front Physiol 2022; 13:844847. [PMID: 35432004 PMCID: PMC9008480 DOI: 10.3389/fphys.2022.844847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background: As cardio-vascular diseases are the leading cause of death worldwide, establishing measures to improve cardiovascular health is of crucial importance. Exercise plays an essential role in cardiac rehabilitation of patients with coronary artery disease (CAD), in whom an evaluation of the cardiorespiratory fitness (CRF) is necessary. CRF of CAD patients could be assessed using 6-min walk test (6MWT), and the results interpreted by using Enright-Sherill prediction equation which has mainly been designed and evaluated for a healthy population. Hypothesizing that the Enright-Sherill prediction equation might not be best suited for CAD patients, our aim was to reevaluate this equation in CAD patients, and potentially establish a more accurate 6MWD prediction equation to be applied in these patients.Methods: 6MWD was measured in a cross-sectional study in 67 CAD patients (44 women) who were members of the Coronary club Ljubljana, Slovenia. In addition, the predicted 6MWD was calculated for men and women using Enright-Sherill gender specific regression equation. Multivariate regression analysis was used to obtain a new prediction equation, and the agreement between the measured and the predicted 6MWD analyzed using the repeated measures ANOVA.Results: Men achieved 451 ± 122 m and women 485 ± 69 m without significant differences between sexes (F = 0.022, p = 0.882) when adjusted for age, height, body mass, and waist circumference. When comparing the measured (473 ± 91 m) and the predicted (422 ± 57 m) values of 6MWD in CAD patients we found that the Enright-Sherill prediction equation significantly (F = 27.734, p < 0.001) underestimated the 6MWD by 52 ± 81 m. A significant regression equation was established [F (3,63) = 44.663, p < 0.001], with a R2 of 0.680 where 6MWD equals 1,057 m—4.966 x age (years)—0.614 x WC (cm)–68.629 x NYHA class.Conclusion: The results of this study stress the importance of regular and actual walking ability testing in patients with stable CAD to obtain their CRF, rather than simply predicting it from regression equations obtained from non-representative or non-comparable samples. Our developed prediction equation warrants additional validation and may represent a good substitute for currently used predictions obtained from a healthy population.
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Affiliation(s)
- Helena Lenasi
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ana Novak
- Sports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Jug
- Department of Vascular Diseases, Division of Internal Medicine, University Medical Center, Ljubljana, Slovenia
| | - Edvin Dervišević
- Sports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Damir Karpljuk
- Sports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mateja Videmšek
- Sports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Maroje Sorić
- Department of Sport and Exercise Medicine, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Vedran Hadžić
- Sports & Medicine Department, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- *Correspondence: Vedran Hadžić,
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Abstract
: Sexual health is an integral part of overall health, and an active and healthy sexual life is an essential aspect of a good life quality. Cardiovascular disease and sexual health share common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking) and common mediating mechanisms (endothelial dysfunction, subclinical inflammation, and atherosclerosis). This generated a shift of thinking about the pathophysiology and subsequently the management of sexual dysfunction. The introduction of phosphodiesterase type 5 inhibitors revolutionized the management of sexual dysfunction in men. This article will focus on erectile dysfunction and its association with arterial hypertension. This update of the position paper was created by the Working Group on Sexual Dysfunction and Arterial Hypertension of the European Society of Hypertension. This working group has been very active during the last years in promoting the familiarization of hypertension specialists and related physicians with erectile dysfunction, through numerous lectures in national and international meetings, a position paper, newsletters, guidelines, and a book specifically addressing erectile dysfunction in hypertensive patients. It was noted that erectile dysfunction precedes the development of coronary artery disease. The artery size hypothesis has been proposed as a potential explanation for this observation. This hypothesis seeks to explain the differing manifestation of the same vascular condition, based on the size of the vessels. Clinical presentations of the atherosclerotic and/or endothelium disease in the penile arteries might precede the corresponding manifestations from larger arteries. Treated hypertensive patients are more likely to have sexual dysfunction compared with untreated ones, suggesting a detrimental role of antihypertensive treatment on erectile function. The occurrence of erectile dysfunction seems to be related to undesirable effects of antihypertensive drugs on the penile tissue. Available information points toward divergent effects of antihypertensive drugs on erectile function, with diuretics and beta-blockers possessing the worst profile and angiotensin receptor blockers and nebivolol the best profile.
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De Rocco Ponce M, Vecchiato M, Neunhaeuserer D, Battista F, Caretta N, Savalla F, Favero C, Garolla A, Foresta C, Ermolao A. Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction. Sex Med 2021; 9:100347. [PMID: 33975195 PMCID: PMC8240347 DOI: 10.1016/j.esxm.2021.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Vascular erectile dysfunction (ED) is a burdensome condition, associated with increased cardiovascular risk. Peak systolic velocity (PSV) represents the maximum pulse velocity in the cavernous artery measured by a penile color doppler ultrasonography (PCDU) during a pharmacologically induced erection and is considered a reliable parameter for the diagnosis of vascular ED. However, the cut-off value of standard PSV (30 cm/s) provides high sensitivity only in the diagnosis of advanced arteriogenic disease. Thus, an age-adjusted PSV (6.73 + 0.7 x age cm/s) has been proposed to offer a more accurate diagnosis of vascular ED. AIM In this study it was aimed to answer the following question: "Is there any positive association between indexes of vascular erectile dysfunction and cardiorespiratory fitness?" MAIN OUTCOME MEASURE AND METHODS 25 patients with a medical history of ED (median age 55.3 years) underwent PCDU after pharmacological stimulation. Subsequently, a functional evaluation with ECG-monitored, incremental, maximal cardiopulmonary exercise testing was performed. RESULTS Peak oxygen uptake (VO2 peak), peak oxygen uptake per body weight (VO2 peak/kg) and Watt/kg correlated with standard PSV, even when corrected for age and BMI (p < 0.05). No differences emerged in cardiopulmonary fitness between pathological and healthy patients (4 vs 21) identified using the standard PSV cut-off. Conversely, the age-adjusted PSV cut-off identified a greater number of patients as pathological (18 vs 7), presenting a significantly lower cardiopulmonary fitness, exercise capacity and efficiency when compared to patients with normal age-adjusted PSV (all p < 0.05). CONCLUSION Data showed an age and BMI independent association between vascular disfunction of cavernous artery and cardiopulmonary fitness, a known solid predictor of all-cause and disease-specific mortality. Moreover, the age-adjusted PSV better identified a subgroup of patients with vascular ED presenting impaired cardiorespiratory fitness and thus increased cardiovascular risk. De Rocco Ponce M, Vecchiato M, Neunhaeuserer D, et al. Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction. Sex Med 2021;9:100347.
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Affiliation(s)
- Maurizio De Rocco Ponce
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy.
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Nicola Caretta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Francesco Savalla
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Claudia Favero
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
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Rusiecki L, Zdrojowy R, Gebala J, Rabijewski M, Sobieszczańska M, Smoliński R, Pilecki W, Dziubek W, Janocha A, Womperski M, Kałka D. Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality. Asian J Androl 2020; 22:526-531. [PMID: 31929194 PMCID: PMC7523618 DOI: 10.4103/aja.aja_131_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.
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Affiliation(s)
- Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
| | - Romuald Zdrojowy
- Department and Clinic of Urology, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Jana Gebala
- Cardiosexology Students' Scientific Club, Wrocław Medical University, Wrocław 50-368, Poland
| | - Michał Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw 01-004, Poland
| | | | - Ryszard Smoliński
- Consultant Sexologist, Clinical Hospital Wrocław Medical University, Wrocław 50-556, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
| | - Wioletta Dziubek
- Department of Physiotherapy, University School of Physical Education, Wroclaw 51-612, Poland
| | - Anna Janocha
- Department of Physiology, Wroclaw Medical University, Wroclaw 50-368, Poland
| | | | - Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland.,Centre for Men's Health, Wroclaw 53-151, Poland
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Abstract
This document reflects the key points of a consensus meeting of the Heart Failure Association of European Society of Cardiology (ESC) held to provide an overview the role of physiological monitoring in the complex multimorbid heart failure (HF) patient. This article reviews assessments of the functional ability of patients with HF. The gold standard measurement of cardiovascular functional capacity is peak oxygen consumption obtained from a cardiopulmonary exercise test. The 6-min walk test provides an indirect measure of cardiovascular functional capacity. Muscular functional capacity is assessed using either a 1−repetition maximum test of the upper and lower body or other methods, such as handgrip measurement. The short physical performance battery may provide a helpful, indirect indication of muscular functional capacity.
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Affiliation(s)
- Massimo F Piepoli
- Heart Failure Unit, Guglielmo da Saliceto Hospital, Cantone del Cristo, 29121 Piacenza, Italy
| | - Ilaria Spoletini
- Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giuseppe Rosano
- Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
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Kałka D. Editorial commentary: Cardiosexology – Let's talk about sex. Trends Cardiovasc Med 2019; 29:466-467. [DOI: 10.1016/j.tcm.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 01/24/2019] [Indexed: 01/26/2023]
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Zhang Y, Huo W, Wen Y, Li H. Silencing Nogo-B receptor inhibits penile corpus cavernosum vascular smooth muscle cell apoptosis of rats with diabetic erectile dysfunction by down-regulating ICAM-1. PLoS One 2019; 14:e0220715. [PMID: 31442237 PMCID: PMC6707583 DOI: 10.1371/journal.pone.0220715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/22/2019] [Indexed: 12/16/2022] Open
Abstract
Erectile dysfunction (ED) is a major sexual problem for men. Nogo-B receptor (NgBR) has been found to be involved in the regulation of vascular remodeling and angiogenesis. The present study explores the effects of NgBR in penile corpus cavernosum in rats with diabetic ED. Firstly, the ED model of Sprague Dawley rats was established. Hematoxylin-eosin staining and Masson staining were conducted to observe pathological morphology. Immunochemical assay was adopted to detect α-smooth muscle actin (α-SMA), NgBR and intercellular cell adhesion molecule-1 (ICAM-1) expression. Reverse transcription quantitative polymerase chain reaction assay and Western blot analysis were carried out for the assessment of NgBR, factors correlated to ICAM-1, including steroid receptor coactivator (SRC) and proline-rich tyrosine kinase2 (PYK2), and factors associated with apoptosis, including B-cell lymphoma-2 (Bcl-2), Bcl-2 associated protein X (Bax), caspase 3 and cleaved-caspase 3. The results found that capillaries and vascular smooth muscle cell content reduced, and NgBR and ICAM-1 were elevated in rats with diabetic ED. si-NgBR relieved ED by decreasing penile corpus cavernosum smooth muscle systolic percentage and increasing erectile time and rate, intracavernous pressure (ICP)/mean arterial pressure (MAP) and diastolic percentage, improving the pathological changes and inhibiting cavernosum cell apoptosis. si-NgBR also resulted in the down-regulation of ICAM-1 and downstream SRC and PYK2 and promoted α-SMA expression. In conclusion, si-NgBR can provide a potential therapy for diabetic ED in rats by down-regulating ICAM-1, SRC and PYK2, making it a potential therapeutic option for diabetic ED.
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Affiliation(s)
- Yun Zhang
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
| | - Wei Huo
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
| | - Yan Wen
- Department of Endocrine, China-Japan Union Hospital of Jilin University, Changchun, P.R. China
| | - Hai Li
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, P.R.China
- * E-mail:
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Two Birds with One Stone: Regular Use of PDE5 Inhibitors for Treating Male Patients with Erectile Dysfunction and Cardiovascular Diseases. Cardiovasc Drugs Ther 2019; 33:119-128. [PMID: 30675707 DOI: 10.1007/s10557-019-06851-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Patients with cardiovascular disease (CVD) frequently have erectile dysfunction (ED) because the two conditions have similar risk factors and potential mechanisms. The therapeutic effect of CVD is strongly dependent upon long-term management of the condition. Patients with CVD tend to have poor medication compliance, and the coexistence of ED often discourages patients with CVD from continuing their long-term CVD management, thus worsening CVD treatment compliance. The two major reasons for poor compliance are that (i) the adverse effects of cardiovascular medications on erectile function drive people to reduce the prescribed dosage or even stop taking the medications to obtain satisfactory sexual arousal and (ii) a worsening mental state due to ED reduces medication compliance. The regular administration of phosphodiesterase-5 inhibitors (PDE5is) guarantees that the prescribed medication dosages are easy to comply with and that they improve the mental status of patients by enhancing their erectile function, resulting in improved long-term management of CVD through medication compliance. PDE5is themselves also play a role in reducing cardiovascular events and improving the prognosis. We recommend prescribing PDE5is for ED and suggest that PDE5i administration is a promising strategy to improve the long-term management of patients with both ED and CVD.
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Wu Z, Huang Z, Wu Y, Huang S, Wang Y, Zhao H, Chen S, Wu S, Gao X. Sedentary time, metabolic abnormalities, and all-cause mortality after myocardial infarction: A mediation analysis. Eur J Prev Cardiol 2018; 26:96-104. [PMID: 30289271 DOI: 10.1177/2047487318804611] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sedentary time was associated with myocardial infarction (MI) and metabolic diseases in previous studies. PURPOSE To investigate whether sedentary time measured before disease onset was associated with all-cause mortality among MI survivors and whether the sedentary time-mortality association was mediated by physical activity status and metabolic phenotypes. METHODS In this prospective community-based cohort including 101,510 Chinese adults, we used sedentary time, evaluated at 2006 (baseline), to predict further all-cause mortality among individuals who then developed new onset MI from 2006 to December 2013 ( n = 989). The post-MI mortality was ascertained after the first non-fatal MI until December 2014. We assessed the mediating effects of physical inactivity and metabolic factors on the sedentary time-mortality association. RESULTS During 7 years follow up, 180 deaths occurred among these participants with incident MI. Prolonged sedentary time was associated with a higher risk of mortality among MI survivors. The adjusted hazard ratio (HR) of mortality for sedentary time 4-8 hours/day versus <4 hours/day, was 1.62 (95% confidence interval (CI) 1.14-2.31). A high amount of sedentary time (>4 hours/day) and inactive physical activity had an increased risk of all-cause mortality (HR: 2.74, 95% CI 1.34-5.60), relative to those with sedentary time ≤4 hours/day and moderate/vigorous physical activity. Physical inactivity and metabolic factors mediated a small proportion (≤9.2 % for all) of the total association between sedentary time and post-MI mortality. CONCLUSION High sedentary time was significantly associated with all-cause mortality among MI survivors, independent of physical activity status and metabolic abnormalities.
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Affiliation(s)
- Zhijun Wu
- 1 Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Huang
- 2 Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Yuntao Wu
- 2 Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Shue Huang
- 3 Department of Nutritional Sciences, Pennsylvania State University, State college, PA, USA
| | - Yanxiu Wang
- 2 Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Haiyan Zhao
- 2 Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Shuohua Chen
- 4 Health Care Center, Kailuan Medical Group, Tangshan, China
| | - Shouling Wu
- 2 Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- 3 Department of Nutritional Sciences, Pennsylvania State University, State college, PA, USA
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12
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Piepoli MF. Editorial. Eur J Prev Cardiol 2018; 25:1235-1237. [DOI: 10.1177/2047487318794533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Zhao B, Zhang W. Does erectile dysfunction independently predict cardiovascular events? It's time to act on the evidence. Eur J Prev Cardiol 2018; 25:1307-1311. [PMID: 29808761 DOI: 10.1177/2047487318778994] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Binghao Zhao
- 1 Department of Cardio-Thoracic Surgery, The second affiliated hospital of Nanchang University, China.,2 Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenxiong Zhang
- 1 Department of Cardio-Thoracic Surgery, The second affiliated hospital of Nanchang University, China
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14
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Füeßl HS. Erektile Dysfunktion als KHK-Prädiktor. MMW Fortschr Med 2017; 159:33. [PMID: 28718128 DOI: 10.1007/s15006-017-9890-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Kałka D, Gebala J. Re: History of erectile dysfunction as a predictor of poor physical performance after an acute myocardial infarction. Eur J Prev Cardiol 2017; 24:1060-1061. [PMID: 28436729 DOI: 10.1177/2047487317701546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dariusz Kałka
- 1 Cardiosexology Unit, Wrocław Medical University, Poland
| | - Jana Gebala
- 2 Cardiosexology Students' Scientific Club, Wrocław Medical University, Poland
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16
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Compostella L, Truong LVS, Compostella C. Reply to commentary on: History of erectile dysfunction as a predictor of poor physical performance after an acute myocardial infarction. Eur J Prev Cardiol 2017; 24:1062-1063. [PMID: 28345366 DOI: 10.1177/2047487317701547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Leonida Compostella
- 1 Preventive Cardiology and Rehabilitation, Istituto Codivilla-Putti, Italy.,2 Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - Li Van Stella Truong
- 1 Preventive Cardiology and Rehabilitation, Istituto Codivilla-Putti, Italy.,2 Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - Caterina Compostella
- 1 Preventive Cardiology and Rehabilitation, Istituto Codivilla-Putti, Italy.,2 Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
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