年轻勃起功能障碍患者的左室舒张功能与内皮功能的相关性

【目的】 探讨年轻的无全身其他心血管疾病的阴茎勃起功能障碍(ED)患者的血管内皮功能与左室舒张功能的相关性?【方法】 选取我院泌尿外科门诊或住院确诊ED的患者30 例作为病例组(平均年龄30.4 ± 4.3岁),健康对照组 33例(平均年龄29.8 ± 3.9岁)?利用常规超声心动图和组织多普勒方法进行心功能评价?常规超声心动图计算左室射血分数(EF),二尖瓣E峰?A峰,E/A,左室等容舒张时间(IVRT)?左室等容收缩时间(IVCT)?脉冲血流多普勒Tei指数?组织多普勒计算二尖瓣后瓣环的E′?A′,等容舒张时间(IVRT′)?等容收缩时间(IVCT′)?心肌做功指数(MPI)?E/E′,及血流多普勒与组织多普勒测量的等容舒张时间差值(TIVRT-IVRT′)?同时测定研究对象的血流介导的肱动脉内皮依赖性舒张功能(FMD)?【结果】 与正常对照组相比,ED患者血流介导的内皮依赖性舒张功能降低(8.5% ± 2.7% vs 13.4% ± 2.5%,P < 0.001),血流多普勒Tei指数增大(0.55 ± 0.08 vs 0.41 ± 0.06,P < 0.001),IVRT延长(85.5 ± 13.4 ms vs 61.7 ± 8.4 ms,P < 0.001), 差异均有统计学意义?FMD与IVRT(r = -0.63)?Tei 指数(r = -0.55)及TIVRT-IVRT′(r = -0.47)均有显著相关性(P < 0.001)?FMD与E/E′?E?E/A,LVEF均无显著的相关性?【结论】 在ED患者,血流介导的肱动脉内皮依赖性舒张功能FMD及左室舒张功能降低?IVRT作为评价舒张功能的一个敏感指标,与FMD存在显著相关性?

Relationship between Flow-Mediated Dilatation and Left Ventricular Function in Young Patients with Erectile Dysfunction

【Objective】 The aim of this study was to assess the relationship between left ventricular diastolic function and forearm endothelial function in the patients with erectile dysfunction (ED) without overt cardiovascular disease. 【Methods】 We prospectively evaluated 30 patients (mean age 30.4 ± 4.3 years) and 33 control subjects (mean age 29.8 ± 3.9 years). LV function was assessed by classical methods and Doppler tissue imaging (DTI). Left ventricular ejection fraction (EF), peak early (E) and late (A) transmitral filling velocities, their ratio (E/A), LV isovolumetric relaxation time (IVRT), LV isovolumetric contract time (IVCT) and Tei index were evaluated by conventional echocardiography. Early diastolic (E′), late diastolic (A′), Myocardial performance index (MPI), isovolumic contraction time (IVCT′), isovolumic relaxation time (IVRT′), the time interval difference of isovolumic relaxation (TIVRT-IVRT′) and the ratio of early diastolic mitral inflow velocity to E′ (E/E′) were obtained by tissue Doppler imaging (TDI).Endothelial function, measured as flow-mediated dilatation of the brachial artery using ultrasound, was calculated in the subjects. 【Results】 Endothelium dependent vasodilation(8.5% ± 2.79% vs 13.4% ± 2.5%,P < 0.001) was impaired in the ED group than that in the control group. And the Tei index (0.55 ± 0.08 vs 0.41 ± 0.06, P < 0.001) was larger than in the control group. IVRT(85.5 ± 13.4 ms vs 61.7 ± 8.4 ms,P < 0.001)was prolonged in the ED group compared with the control group. IVRT,Tei index and TIVRT-IVRT′ were significantly related to endothelium-dependent vasodilation by bivariate analysis.【Conclusions】 It was found that endothelial function and left ventricular diastolic function were impaired in ED patients. Left ventricular diastolic function parameters, IVRT,Tei index and TIVRT-IVRT′ was related to endothelium-dependent vasodilation in patients with ED without overt cardiovascular disease.