心房颤动与勃起功能障碍的关系

尽管医疗卫生技术的进步使心血管疾病死亡率逐年降低，但心血管事件仍然是导致全球人口寿命缩短的重要原因，其中男性患病年龄多早于女性。识别及减少心血管疾病危险因素，在改善心血管疾病预后中占有重要地位。良好的性生活也是健康的重要组成部分。性功能障碍，特别是男性勃起功能障碍，在人群中具有高患病率，并随年龄增长而逐渐增加。心房颤动与勃起功能障碍2种疾病常合并存在，二者不仅有诸多相似的危险因素，也有众多共同的病理生理途径。勃起功能障碍作为心血管疾病的独立危险因素，在预测心房颤动发生及进展中也有一定的价值。同时，勃起功能障碍也是导致心血管疾病治疗中断或依从性差的一个重要原因。筛查和诊断勃起功能障碍，可为评估心房颤动预后提供一种简单且实用的工具。已有研究证实，勃起功能障碍相关药物治疗在改善血管内皮功能时，也可改善心房肌血供、降低炎症水平，其中，睾酮可作用于心房肌膜离子通道，减少心房肌异常自发触发电位，进而降低房颤发生风险。越来越多的研究致力于明确勃起功能障碍与心房颤动间的关系，内皮功能障碍、炎症及睾酮缺乏在二者的发病中均占有重要地位，但具体机制仍未完全清楚，本文就勃起功能障碍及相关治疗对心房颤动的影响作一综述。 

Atrial fibrillation and erectile dysfunction

Despite advances in health care technology that have reduced mortality rates caused by cardiovascular disease over the years, cardiovascular events continue to be a significant cause of shortened life expectancy in the global population, with men developing the disease at an earlier age than women. Identifying and reducing the risk factors of cardiovascular diseases plays an important role in improving the prognosis of cardiovascular diseases. A good sexual life is also an important part of health. Sexual dysfunction, particularly erectile dysfunction in men, has a high prevalence in the population, which increases progressively with age. Atrial fibrillation (AF) and erectile dysfunction are often coexisting, and they share many similar risk factors, as well as pathophysiological pathways. Erectile dysfunction, as an independent risk factor for cardiovascular diseases, is also important in predicting the occurrence and progression of AF. In addition, erectile dysfunction is an important cause of discontinuation or poor compliance with treatment for cardiovascular diseases. Screening and diagnosis of erectile dysfunction may provide a simple and practical tool for assessing the prognosis of AF. Some therapies for erectile dysfunction have improved vascular endothelial function while improving atrial myocardial blood supply and reducing inflammation levels, with testosterone acting on atrial myocardial membrane ion channels to reduce abnormal spontaneous triggering potentials in atrial myocardium, thereby reducing the risk of AF. The relationship between erectile dysfunction and AF has been increasingly studied, and endothelial dysfunction, inflammation and testosterone deficiency play an important role in the pathogenesis of both conditions, but the exact mechanisms remain unclear. This article provides a review of the effects of erectile dysfunction and related treatments on AF.