Evaluation of endothelial function with brachial artery ultrasound in men with or without erectile dysfunction and classified as intermediate risk according to the Framingham Score.

Introduction: Flow-mediated vasodilation (FMD) of the brachial artery is a noninvasive tool used for endothelial function evaluation. There is increasing evidence that endothelial dysfunction is a common etiological factor for erectile dysfunction (ED) and cardiovascular events.
Aim: To evaluate endothelial function with a high-resolution ultrasound device, to assess FMD in men diagnosed with ED and without clinical evidence of significant atherosclerotic disease, classified as "intermediate risk" according to the Framingham risk score (FRS).
Methods: This is a case-control study that included 52 consecutive men. In all men with ED evaluated by a score less than 22 on International Index of Erectile Function-5 questionnaire (IIEF-5), clinical parameters such as blood pressure, waist circumference, hip circumference, body mass index, lipid profile, fasting glucose, and serum total testosterone were obtained. These parameters were compared with those men without diagnosis of ED (IIEF-5 score≥22) (age-matched, also classified as "intermediate risk" according to the FRS). All underwent brachial artery ultrasound for assessment of FMD, as a noninvasive method to evaluate endothelial function. Statistical analysis was performed considering a P<0.05.
Main Outcome Measures: Endothelium-dependent FMD was evaluated in the right brachial artery with a high-resolution ultrasound machine following reactive hyperemia.
Results: Thirty-four men were included in the ED group, and 18 were included in the group without ED. The mean ages were 59.61±9.87 and 56.18±10.93, respectively (P=0.27). Clinical and laboratory evaluations were similar between men with and without ED (P>0.05) except for waist circumference that was greater in patients with ED (mean=100.85 cm vs. 96.05; P<0.05). The percentage of FMD was higher in men without ED when compared with those with ED (mean FMD 11.33±6.08% vs. 4.24±7.06%, respectively; P=0.001).
Conclusions: Men without established atherosclerotic disease presenting with ED demonstrated a worse endothelial function.
(© 2012 International Society for Sexual Medicine.)