scholarly journals Central pulse load and coronary flow benefit in relation to endogenous testosterone and the Mediterranean regime in hypertensive males with erectile dysfunction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Angelis ◽  
K Aggeli ◽  
N Ioakeimidis ◽  
C Georgakopoulos ◽  
K Zisimos ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Pulse Pressure ◽  
Coronary Flow ◽  
Linear Regression Analysis ◽  
Significant Coronary Artery Disease ◽  
Diet Adherence ◽  
Flow Reserve ◽  
Arterial Blood ◽  
The Mediterranean ◽  
Central Pulse Pressure

Abstract Background Central pulse pressure (cPP) is an important parameter of target organ damage (TOD) in essential hypertension. Coronary flow reserve (CFR) displays the ability of both macro and microcirculation to augment flow to the myocardium while endogenous total testosterone (TT) exhibits vasodilator effects. The Mediterranean diet (Med-diet) benefits cardiovascular health and erectile dysfunction (ED) often coexists with the decline of endogenous testosterone in the aging male population. Purpose To investigate the possible benefits of the Med-diet in central PP, CFR and erectile ability in relation to endogenous TT in the primary hypertensive population with ED. Methods 247 male hypertensive patients (mean age 57 yo) with ED enrolled the study. Significant coronary artery disease was formerly excluded by a dobutamine stess echo test. We measured the CFR of the left anterior descending artery by performing an adenosine protocol (maximum dose 140 μg/kg/min over 6 minutes). Measurements by the PW Doppler were achieved at the middle/distal LAD segment under the guidance of color Doppler flow mapping. CFR was validated as ratio between peak diastolic flow velocity following drug infusion and rest. Ratios ≥2 are considered as non-ischemic response and higher values indicate microvascular coronary integrity. TT was measured in all patients on blood samples taken before 09:00 am. ED severity and adherence to the Med-diet were assessed by the SHIM-5 (range: 0–25) and the Med-diet (range: 0–55) scores. Higher values indicate a better erectile ability and Med-diet compliance respectively. Finally, cPP and augmentation index (AIx) were estimated as parameters of central hemodynamic load and wave reflection amplification respectively (sphygmocor device). Results In bivariate analysis Med-diet was favorably related to CFR (p=0.24, r=0.48), TT (p=0.01, r=0.57) and the SHIM-5 score (p=0.01, r=0.45). On the contrary, it was negatively related to cPP (p=0.15, r=−0.60) and AIx (p=0.31, r=−0.45). CFR was strongly related to TT (p=0.001, r=0.8) and the SHIM-5 score (p=0.01, r=0.41). By multiple linear regression analysis the relation of CFR, SHIM-5 and Med-diet score remained significant after adjustment for age, BMI, systolic arterial blood pressure and smoking habits. We further subdivide our population according to the mean Med-diet value (26) into high and low Med-diet adherence groups. Only in the group with the greater Med-diet adherence (n=153, 62%) there were still positive relation with the CFR, TT and SHIM-5 score as well as negative correlation to cPP and AIx (p=0.04). Conclusion In essential hypertensive males with erectile dysfunction the Med-diet regime lessens central pulse pressure while enhancing coronary flow, testosterone levels and so peripheral vascular physiology. We strongly recommend this dietary pattern as a life-style option and strategic component of holistic therapeutic approach. Funding Acknowledgement Type of funding source: None

scholarly journals Exercise capacity benefit in relation to endogenous testosterone, coronary and central vascular physiology, and the Mediterranean regime in hypertensive males with erectile dysfunction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Angelis ◽  
K Aggeli ◽  
I Dimitroglou ◽  
N Ioakeimidis ◽  
C Georgakopoulos ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Exercise Capacity ◽  
Wave Reflection ◽  
Stress Test ◽  
Linear Regression Analysis ◽  
Well Being ◽  
Metabolic Equivalents ◽  
Flow Reserve ◽  
Vascular Physiology ◽  
The Mediterranean

Abstract Background The Mediterranean diet (Med-diet) benefits cardiovascular health, and erectile dysfunction (ED) often coexists in the hypertensive aging male population were endogenous testosterone (TT) typically declines. Coronary flow reserve (CFR) displays the ability of the coronary circulation to increase flow. Wave reflection amplification as expressed by augmentation index (AIx) exhibits a vital parameter of central vascular stiffness. Purpose To investigate the possible benefits of the Med-diet in exercise capacity, central physiology, CFR and erectile ability in relation to endogenous TT in the middle aged male hypertensive population with ED. Methods 250 hypertensive males (mean age 56 yo) with ED enrolled the study. All underwent a treadmill stress test (Bruce protocol). Exercise capacity was validated as metabolic equivalents (METs). We measured separately the CFR of the left anterior descending artery by an adenosine protocol (max dose 140μg/kg/min over 6 minutes). PW Doppler measurements were achieved at the middle/distal LAD segment under the guidance of color Doppler flow mapping. CFR was validated as ratio between peak diastolic flow velocity following drug infusion and rest. Ratios ≥2 are considered as non-ischemic response, higher values indicate microvascular coronary integrity. TT was measured on blood samples taken before 09:00 am. ED severity and adherence to the Med-diet were assessed by the SHIM-5 (range: 0–25) and the Med-diet (range: 0–55) scores. Higher values indicate a better erectile ability and Med-diet compliance respectively. Finally, central pulse pressure (cPP) and AIx were noninvasively estimated as parameters of central hemodynamic load and wave reflection amplification (Sphygmocor device). Results In bivariate analysis METs were positively associated to the Med-diet, CFR, TT and the SHIM-5 score (all p<0,005) and negatively to the AIx and cPP (both p<0,025). There was also positive association of the Med-diet to the CFR, TT and the SHIM-5 score (p<0,02) and negative to the AIx and cPP (p<0,025). By linear regression analysis association of METs to TT, CFR and Med-diet remained significant after adjustment for age, BMI, diabetes mellitus, use of statins and smoking status (p<0,005). We further subdivide our population according to the TT threshold of hypogonadism (≤3 ng/ml). Hypogonadism patients exhibit a lower exercise capacity comparing to the normal TT group (picture). Conclusion The Med-diet regime benefits exercise tolerance and erectile performance in hypertensive males with ED by enhancing endogenous testosterone and so coronary and central vascular physiology. We strongly recommend this culinary preference promoting thus vascular health and the sense of well being. FUNDunding Acknowledgement Type of funding sources: None.

P6262Coronary microphysiology in relation to low endogenous testosterone and dietary habits in andropause men with erectile dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Angelis ◽  
N loakeimidis ◽  
Y Dimitroglou ◽  
K Zisimos ◽  
C Georgakopoulos ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Erectile Dysfunction ◽  
Coronary Artery ◽  
Pulse Wave ◽  
Dietary Habits ◽  
Linear Regression Analysis ◽  
Male Hypogonadism ◽  
Middle Aged ◽  
Flow Reserve ◽  
Artery Disease

Abstract Background Coronary flow reserve (CFR) in the presence of non-obstructive coronary artery disease displays the ability of microcirculation to augment flow to the myocardium. Endogenous total testosterone (TT) exhibits vasodilator effects and the Mediterranean diet (Med-diet) promotes cardiovascular health. Erectile dysfunction (ED) in a milieu of subclinical microvascular damage often coexists with the decline of endogenous testosterone of the aging male population. Purpose To investigate the effects of male hypogonadism in CFR and the relation between the Med-diet and the TT of the andropause middle aged men with ED. Methods 190 non-diabetic male patients with ED (mean age: 56yo) enrolled the study. Significant epicardial coronary artery disease was excluded after a negative for ischemia dobutamine stress echo test. We measured the CFR of the left anterior descending artery by performing an adenosine protocol (maximum dose 140μg/kg/min over 6 minutes). Measurements by the pulse wave Doppler were achieved at the middle/distal LAD segment under the guidance of color Doppler flow mapping. CFR was estimated as ratio between peak diastolic flow velocity following drug infusion and rest. CFR ratio ≥2 is considered as non-ischemic response and higher values indicate microvascular coronary integrity. TT was measured in all patients on blood samples taken before 09:00 am and hypogonadism was considered when TT <3,5 ng/ml. ED severity and adherence to the Med-diet were assessed by the SHIM-5 (range: 0–25) and the Med-diet (range: 0–55) scores. Higher values point to better erectile function and a great Med-diet compliance respectively. Finally, carotid – femoral pulse wave velocity (PWV) was assessed as index of central vascular stiffness (sphygmocor device). Results In bivariate analysis CFR ratio (mean value: 2,35) was positively related to TT (p<0,001, r=0,9), the SHIM-5 and the Med-diet score (p<0,05 for both r=0,45 and r=0,5 respectively).On the contrary, it was negatively related to the PWV (p<0,05, r=−0,35). Med-diet was related to the SHIM-5 score (p=0,01, r=0,363) and to TT (p=0,02, r=0,46). In multiple linear regression analysis relation of CFR to TT remain significant (p<0,01) after adjustment for age, body mass index (BMI), LDL, PWV, smoking habits and systolic blood pressure. We further stratified our population in to hypogonadics (HYPO, n=38, 20%) and patients with normal TT levels. Poor adherence to the Med-diet was the only factor related to hypogonadism (independent sample t-test p=0,005) as compared with age, BMI and smoking. Conclusion In middle aged men with ED endogenous testosterone enhances coronary microcirculation. Moreover the Med-diet regime may blunt the fall of androgens during andropause independently of other life-style parameters. We emphasize on this culinary preference to assist coronary microvascular physiology and maintain hormonal balance.

Effects of gestational age on myocardial blood flow and coronary flow reserve in pressure-loaded ovine fetal hearts

2002 ◽  
Vol 282 (4) ◽  
pp. H1359-H1369 ◽  
Author(s):  
Gregory B. Dalshaug ◽  
Thomas D. Scholz ◽  
Oliva M. Smith ◽  
Kurt A. Bedell ◽  
Christopher A. Caldarone ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Myocardial Blood Flow ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Left Ventricular ◽  
Mrna Levels ◽  
Blood Flows ◽  
Flow Reserve ◽  
Arterial Blood

To test the hypothesis that coronary flow and coronary flow reserve are developmentally regulated, we used fluorescent microspheres to investigate the effects of acute (6 h) pulmonary artery banding (PAB) on baseline and adenosine-enhanced right (RV) and left ventricular (LV) blood flow in two groups of twin ovine fetuses (100 and 128 days of gestation, term 145 days, n = 6 fetuses/group). Within each group, one fetus underwent PAB to constrict the main pulmonary artery diameter by 50%, and the other twin served as a nonbanded control. Physiological measurements were made 6 h after the surgery was completed; tissues were then harvested for analysis of selected genes that may be involved in the early phase of coronary vascular remodeling. Within each age group, arterial blood gas values, heart rate, and mean arterial blood pressure were similar between control and PAB fetuses. Baseline endocardial blood flow in both ventricles was greater in 100 than 128-day fetuses (RV: 341 ± 20 vs. 230 ± 17 ml · min−1 · 100 g−1; LV: 258 ± 18 vs. 172 ± 23 ml · min−1 · 100 g−1, both P < 0.05). In both age groups, RV and LV endocardial blood flows increased significantly in control animals during adenosine infusion and were greater in PAB compared with control fetuses. After PAB, adenosine further increased RV blood flow in 128-day fetuses (from 416 ± 30 to 598 ± 33 ml · min−1 · 100 g−1, P < 0.05) but did not enhance blood flow in 100-day animals (490 ± 59 to 545 ± 42 ml · min−1 · 100 g−1, P > 0.2). RV vascular endothelial growth factor and Flk-1 mRNA levels were increased relative to controls ( P < 0.05) in 128 but not 100-day PAB fetuses. We conclude that in the ovine fetus, developmentally related differences exist in 1) baseline myocardial blood flows, 2) the adaptive response of myocardial blood flow to acute systolic pressure load, and 3) the responses of selected genes involved in vasculogenesis to increased load in the fetal myocardium.

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