Lack of predictive correlation between peripheral arterial tone and colour flow Doppler parameters in men with erectile dysfunction.

Autor: Seager CM; Department of Urology, Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, OH 44195, USA., Li J, Shoskes DA
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2013 Jul; Vol. 112 (2), pp. E186-90. Date of Electronic Publication: 2013 Feb 22.
DOI: 10.1111/bju.12033
Abstrakt: Objective: To evaluate whether peripheral arterial tone (PAT) can predict the results of penile colour flow Doppler in the evaluation of erectile dysfunction (ED).
Patients and Methods: Fifty men presenting to an ED clinic were tested with an Endo-PAT2000 machine (Itamar Medical, Caesarea, Israel), which assessed augmentation index (AI), a measure of arterial stiffness, and reactive hyperaemia index (RHI), a measure of endothelial vasodilatation. Penile haemodynamics were measured and used to identify both arterial insufficiency (abnormal peak systolic velocity [PSV]) and veno-occlusive disease (abnormal end diastolic velocity [EDV]) after pharmacological erection with prostaglandin E1 using colour flow Doppler. Between-group comparisons were carried out using a Wilcoxon rank-sum test for continuous variables and a chi-squared test for categorical variables. Simple and multivariable logistic regression analyses were used to analyse the correlation between outcome measures.
Results: Using Doppler analysis, 58% of patients were found to have arterial insufficiency (abnormal PSV) and 48% had veno-occlussive disease (abnormal EDV). Using the Endo-PAT machine, 44% of patients were found to have increased arterial stiffness (abnormal AI) and 54% had decreased endothelial relaxation (abnormal RHI). Neither AI nor RHI were correlated with PSV or EDV. The closest association was between high AI and low PSV, with a sensitivity of 0.55 and specificity of 0.71.
Conclusions: In our patient cohort, PAT did not reliably predict the results of penile Doppler. The two tests appear to measure different although potentially complementary aspects of the local and systemic vasculature.
(© 2013 BJU International.)
Databáze: MEDLINE
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