Author's Accepted Manuscript Association of Peripheral Microvascular Dysfunction and Erectile Dysfunction Rachael E. Gerber, Joseph A. Vita, Peter Ganz, Carrie G. Wager, Andre B. Araujo, Raymond C. Rosen, Varant Kupelian
PII: DOI: Reference:
S0022-5347(14)04363-8 10.1016/j.juro.2014.08.108 JURO 11768
To appear in: The Journal of Urology Accepted Date: 27 August 2014 Please cite this article as: Gerber RE, Vita JA, Ganz P, Wager CG, Araujo AB, Rosen RC, Kupelian V, Association of Peripheral Microvascular Dysfunction and Erectile Dysfunction, The Journal of Urology® (2014), doi: 10.1016/j.juro.2014.08.108. DISCLAIMER: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our subscribers we are providing this early version of the article. The paper will be copy edited and typeset, and proof will be reviewed before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to The Journal pertain. All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date.
ACCEPTED MANUSCRIPT
Association of Peripheral Microvascular Dysfunction and Erectile Dysfunction Rachael E. Gerber, MPH1; Joseph A. Vita, MD2; Peter Ganz, MD3; Carrie G. Wager, PhD1; Andre B. Araujo, PhD1; Raymond C. Rosen, PhD1; Varant Kupelian, PhD1 1
New England Research Institutes, Inc., Watertown, MA Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University, Boston, MA 3 Division of Cardiology, San Francisco General Hospital, University of California San Francisco, San Francisco, CA
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Address for correspondence: Varant Kupelian Research Scientist 9 Galen Street Watertown, MA 02472 Phone: (617) 972 3293 Fax: (617) 926 8246 E-mail: [email protected]
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2
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Supported by a grant from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK); Grant No. 5R01DK080662. The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health.
Keywords: erectile dysfunction, endothelial function, epidemiology
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Word count, text: 2497
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Word count, abstract: 244
1
ACCEPTED MANUSCRIPT
Abstract Purpose. Increasing evidence of a link between erectile dysfunction (ED) and cardiovascular disease (CVD) suggests a shared vascular etiology with endothelial dysfunction as a plausible
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underlying biological mechanism. Whether this association is different for large arterial compared to microvascular endothelium has yet to be established. The objective of this study was to investigate the association of ED with macrovascular and microvascular endothelial
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function. Materials and Methods.
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A sample of 390 men (mean age 55.5 years) was recruited from the Boston Area Community Health (BACH) Survey, a population-based survey of urologic symptoms. ED was assessed using the 5-item International Index of Erectile Function (IIEF-5). Brachial artery flow-mediated dilation (FMD) (%), a measure of macrovascular function, and hyperemic flow velocity (cm/s), a measure of microvascular function, were assessed by ultrasound. Linear regression was used
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to assess the association of ED and endothelial function and adjust for potential confounders. Results. Reactive hyperemia was lower in men with ED (mean (SE) of 97.1(2.5) cm/s) compared to those without ED (106.0(1.6) cm/s, p=0.003). However, the difference in FMD
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between men with and without ED was statistically non-sginficant (6.6(0.33) vs. 7.2(0.24), p=0.147).The ED and reactive hyperemia association was attenuated but remained statistically
AC C
significant for men with moderate to severe ED (IIEF-5
PII: DOI: Reference:
S0022-5347(14)04363-8 10.1016/j.juro.2014.08.108 JURO 11768
To appear in: The Journal of Urology Accepted Date: 27 August 2014 Please cite this article as: Gerber RE, Vita JA, Ganz P, Wager CG, Araujo AB, Rosen RC, Kupelian V, Association of Peripheral Microvascular Dysfunction and Erectile Dysfunction, The Journal of Urology® (2014), doi: 10.1016/j.juro.2014.08.108. DISCLAIMER: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our subscribers we are providing this early version of the article. The paper will be copy edited and typeset, and proof will be reviewed before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to The Journal pertain. All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date.
ACCEPTED MANUSCRIPT
Association of Peripheral Microvascular Dysfunction and Erectile Dysfunction Rachael E. Gerber, MPH1; Joseph A. Vita, MD2; Peter Ganz, MD3; Carrie G. Wager, PhD1; Andre B. Araujo, PhD1; Raymond C. Rosen, PhD1; Varant Kupelian, PhD1 1
New England Research Institutes, Inc., Watertown, MA Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University, Boston, MA 3 Division of Cardiology, San Francisco General Hospital, University of California San Francisco, San Francisco, CA
M AN U
Address for correspondence: Varant Kupelian Research Scientist 9 Galen Street Watertown, MA 02472 Phone: (617) 972 3293 Fax: (617) 926 8246 E-mail: [email protected]
SC
RI PT
2
TE D
Supported by a grant from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK); Grant No. 5R01DK080662. The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health.
Keywords: erectile dysfunction, endothelial function, epidemiology
EP
Word count, text: 2497
AC C
Word count, abstract: 244
1
ACCEPTED MANUSCRIPT
Abstract Purpose. Increasing evidence of a link between erectile dysfunction (ED) and cardiovascular disease (CVD) suggests a shared vascular etiology with endothelial dysfunction as a plausible
RI PT
underlying biological mechanism. Whether this association is different for large arterial compared to microvascular endothelium has yet to be established. The objective of this study was to investigate the association of ED with macrovascular and microvascular endothelial
SC
function. Materials and Methods.
M AN U
A sample of 390 men (mean age 55.5 years) was recruited from the Boston Area Community Health (BACH) Survey, a population-based survey of urologic symptoms. ED was assessed using the 5-item International Index of Erectile Function (IIEF-5). Brachial artery flow-mediated dilation (FMD) (%), a measure of macrovascular function, and hyperemic flow velocity (cm/s), a measure of microvascular function, were assessed by ultrasound. Linear regression was used
TE D
to assess the association of ED and endothelial function and adjust for potential confounders. Results. Reactive hyperemia was lower in men with ED (mean (SE) of 97.1(2.5) cm/s) compared to those without ED (106.0(1.6) cm/s, p=0.003). However, the difference in FMD
EP
between men with and without ED was statistically non-sginficant (6.6(0.33) vs. 7.2(0.24), p=0.147).The ED and reactive hyperemia association was attenuated but remained statistically
AC C
significant for men with moderate to severe ED (IIEF-5
