Abstract
Abstract Aims Erectile dysfunction (ED) is frequent in males with chronic heart failure (HF) with a severe impact on quality of life for many individuals. We evaluated the correlation between ED and HF severity, exercise capacity, treatment and psychological framework. Methods and results We enrolled 328 HF patients aged ≤70 years, with left ventricular ejection fraction ≤40%, and stable clinical condition. We measured: (i) hemoglobin, glycemia, glicated hemoglobin, creatinine, cholesterol, thyroid-stimulating-hormone, C-reactive-protein, total/free testosterone, brain natriuretic peptide, N-terminal prohormone of brain natriuretic peptide; (ii) ED, depression, urological symptoms and signs of low testosterone by means of questionnaires; (iii) HF severity by means of echo and cardiopulmonary exercise test. ED was measured by means of International Index of Erectile Function-5 questionnaire and its score was correlated with exercise cardiopulmonary test parameters, HF severity, treatment and HF comorbidities. Results ED prevalence was 69.94%, 74.46%, and 64.08% in total population and in patients with and without coronary artery lesions, respectively. ED was absent in 98 while it scored mild, mild to moderate, moderate and severe in 65, 57, 32, 73 individuals, respectively. Depression was found in 33.96%, mild urological symptoms in 54,23% and signs of low testosterone in 74.23%. All the individuals with peakVO2 < 10 mL/min/kg had at least a slightly impaired sexual function. We have found no correlation between ED and ejection fraction, use of beta-blockers and ischemic etiology of HF. The only independent predictor of ED presence and severity is the symptomatology related to low testosterone. Conclusions ED is frequent in HF. A normal or only slightly impaired sexual activity is possible with peakVO2 > 10 mL/min/kg. The symptomatology related to low testosterone should be investigated during cardiological examinations.
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