LEFT VENTRICULAR MASS AND SEXUAL FUNCTION IN HYPERTENSIVE PATIENTS WITH HEART FAILURE: SO FAR SO GOOD?

Abstract

Objective: The relation between hypertension and erectile dysfunction (ED) is well established. Moreover, sexual dysfunction, both erectile and female sexual dysfunction (FSD), is highly prevalent in heart failure (HF) patients. On the other hand, hypertension and HF are associated with left ventricular hypertrophy; however the relation between left ventricular mass and sexual function in hypertensive patients with HF has never been investigated sufficiently. Design and method: Patients with HF were evaluated in a cross sectional study. ED was evaluated by the International Index of Erectile Function (IIEF) and FSD by the Female Sexual Functioning Index (FSFI). Left ventricular mass (LV mass), relative wall thickness (RWT), interventricular septum (IVS), posterior wall (PW) thickness and LV mass were evaluated by transthoracic echocardiography as well. Results: A total of 239 consecutive hypertensive patients (147 men and 92 women) with HF participated in the study. The majority of patients had a normal pattern (39.4%) of LV mass, 15.0% had a concentric remodeling pattern, 13.1% concentric left ventricular hypertrophy (LVH), and 32.4 % eccentric LVH. FSFI had a negative correlation with IVS (r = -0.234, p = 0.032), and IIEF a near to significant negative correlation with PW (r = -0.170, p = 0.053). Patients with or without ED and FSD did not have differences in LV mass. Conclusions: Both sexual dysfunction and LV hypertrophy are considered to be hypertension-mediated organ damage. Echocardiographic LV mass is a potent predictor of mortality in hypertensive patients and regression of echocardiographic LVH might lead to a better sexual function and an improved prognosis, although the evidence is limited in HF patients.