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Heart Failure and Erectile Dysfunction: a Review of the Current Evidence and Clinical Implications

Title: Heart Failure and Erectile Dysfunction: a Review of the Current Evidence and Clinical Implications
Authors: Carella M. C.; Forleo C.; Stanca A.; Carulli E.; Basile P.; Carbonara U.; Amati F.; Mushtaq S.; Baggiano A.; Pontone G.; Ciccone M. M.; Guaricci A. I.
Contributors: Carella, M. C.; Forleo, C.; Stanca, A.; Carulli, E.; Basile, P.; Carbonara, U.; Amati, F.; Mushtaq, S.; Baggiano, A.; Pontone, G.; Ciccone, M. M.; Guaricci, A. I.
Publication Year: 2023
Collection: Università degli Studi di Bari Aldo Moro: CINECA IRIS
Subject Terms: Drug side effect; Erectile dysfunction; Heart failure; Pathophysiology; Sexual activity; Therapy
Description: Purpose of Review: Heart failure (HF) and erectile dysfunction (ED) are two common conditions that affect millions of men worldwide and impair their quality of life. ED is a frequent complication of HF, as well as a possible predictor of cardiovascular events and mortality. ED deserves more attention from clinicians and researchers. Recent Findings: The pathophysiology of ED in HF involves multiple factors, such as endothelial dysfunction, reduced cardiac output, neurohormonal activation, autonomic imbalance, oxidative stress, inflammation, and drug side effects. The diagnosis of ED in HF patients should be based on validated questionnaires or objective tests, as part of the routine cardiovascular risk assessment. The therapeutic management of ED in HF patients should be individualized and multidisciplinary, considering the patient’s preferences, expectations, comorbidities, and potential drug interactions. The first-line pharmacological treatment for ED in HF patients with mild to moderate symptoms (NYHA class I–II) is phosphodiesterase type 5 inhibitors (PDE5Is), which improve both sexual function and cardiopulmonary parameters. PDE5Is are contraindicated in patients who use nitrates or nitric oxide donors for angina relief, and these patients should be advised to avoid sexual activity or to use alternative treatments for ED. Non-pharmacological treatments for ED, such as psychotherapy or couples therapy, should also be considered if there are significant psychosocial factors affecting the patient’s sexual function or relationship. Summary: This review aims to summarize the most recent evidence regarding the prevalence of ED, the pathophysiology of this condition with an exhaustive analysis of factors involved in ED development in HF patients, a thorough discussion on diagnosis and management of ED in HF patients, providing practical recommendations for clinicians.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/37962749; info:eu-repo/semantics/altIdentifier/wos/WOS:001100482800001; volume:20; issue:6; firstpage:530; lastpage:541; numberofpages:12; journal:CURRENT HEART FAILURE REPORTS; https://hdl.handle.net/11586/480422
DOI: 10.1007/s11897-023-00632-y
Availability: https://hdl.handle.net/11586/480422; https://doi.org/10.1007/s11897-023-00632-y; https://link.springer.com/article/10.1007/s11897-023-00632-y
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.FEF237E7
Database: BASE