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Master Thesis

Relation entre dysfonction érectile et dysfonction endothéliale chez les patients présentant un premier épisode de syndrome coronarien aigu traité par angioplastie coronaire

Abstract : Erectile dysfunction (ED) is defined as the recurrent or constant inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual performance. Erectile dysfunction is associated with coronary artery disease (CAD) in many registries. The theory that endothelial dysfunction represents the probable pathophysiological link between ED and CAD is still controversial in the literature. Larger studies are needed. Aim of our study To test the hypothesis that endothelial function is associated with ED in patients with a first episode of acute coronary syndrome Objective of the study: Is there a link between ED and CAD ? Is there a link between endothelial dysfunction and CAD ? Does the reversibility of impaired endothelial function improve erectile function? Methods: We conducted a prospective, observational, mono-centric study at the Marseille Nord hospital between January 2014 and July 2015. The 123 men aged 18 to 75 inclusive were admitted for SCA without ST elevation. They all underwent coronary angiography [determining the diffusion of coronary atherosclerosis (1, 2 or 3 vessels), the severity of prostate cancer (Gensini score) and its complexity (SYNTAX score)], an endothelial function assessment by EndoPAT (giving the RHI rate) and completed a self-administered erectile function assessment questionnaire (IIEF-15) in the first days following admission and 18 months after management. Results: The majority (75%) of the 80 patients aged 64 + -6 years old finally included in this study had ED. The severity of ED was significantly associated with the extent of CAD and the ED is correlated with the complexity and severity of CAD. There was a significant linear relationship between endothelial dysfunction and CAD. This relationship was proportional to the spread of coronary lesions, the complexity and severity of CAD. As there was endothelial dysfunction in all patients, whether or not they have ED, only the improvement of endothelial function led to an improvement in erectile function (+3 in absolute value and +30% in relative value p<0, 0001 allowing to establish a relationship between ED, endothelial dysfunction in the coronary patient. Conclusion: Our work confirms the presence of ED in more than half of patients admitted for acute coronary syndrome. To our knowledge, this is the first time that the reversibility of endothelial function leading to an improvement in absolute and relative erectile function. This result confirms that ED is more related to vasculomotor mechanisms and not to atherosclerosis of the penile vessels with reduced arterial size. This association between CAD, endothelial dysfunction and ED has been established by eliminating the main biases found in the literature.
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https://dumas.ccsd.cnrs.fr/dumas-02367618
Contributor : Faculté de Médecine Amu <>
Submitted on : Monday, November 18, 2019 - 10:00:10 AM
Last modification on : Friday, October 23, 2020 - 4:58:57 PM

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Jeanne Nicolazic. Relation entre dysfonction érectile et dysfonction endothéliale chez les patients présentant un premier épisode de syndrome coronarien aigu traité par angioplastie coronaire. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02367618⟩

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