HEART DISEASE AND ERECTILE DYSFUNCTION

Transcription

1 HEART DISEASE AND ERECTILE DYSFUNCTION

2 CONTEMPORARY CARDIOLOGY CHRISTOPHER P. CANNON, MD SERIES EDITOR CTofthe Heart: Principles and Applications, edited by U. Joseph Schoepf, MD, 2004 Cardiac Transplantation: The Columbia University Medical Center/New York-Presbyterian Hospital Manual, edited by NUoo M. Edwards, MD, Jonathan M. Chen, MD, and Pamela A. Mazzeo, 2004 Heart Disease and Erectile Dysfunction, edited by Robert A. Kloner, MD, PhD, 2004 Coronary Disease in Women: Evidence-Based Diagnosis and Treatment, edited by Leslee 1. Shaw, PhD, and Rita F. Redberg, MD, FACC, 2004 Complementary and Alternate Cardiovascular Medicine, edited by Richard A. Stein, MD and Mehmet C. Oz, MD, 2004 Nuclear Cardiology, The Basics: How to Set Up and Maintain a Laboratory, by Frans J. Th. Wackers, MD, PhD, Wendy Bruni, BS, CNMT, and Barry L. Zaret, MD,2004 Minimally Invasive Cardiac Surgery, Second Edition, edited by Daniel J. Goldstein, MD, and Mehmet C. Oz, MD, 2004 Cardiovascular Health Care Economics, edited by William S. Weintraub, MD, 2003 Platelet Glycoprotein lib/ilia Inhibitors in Cardiovascular Disease, Second Edition, edited by A. Michael Lincoff, MD,2003 Heart Failure: A Clinician's Guide to Ambulatory Diagnosis and Treatment, edited by Mariell L. Jessup, MD, and Evan Loh, MD, 2003 Management of Acute Coronary Syndromes, Second Edition, edited by Christopher P. Cannon,MD,2003 Aging, Heart Disease, and Its Management: Facts and Controversies, edited by Niloo M. Edwards, MD, Mathew S. Maurer, MD, and Rachel B. Wellner, MPH, 2003 Peripheral Arterial Disease: Diagnosis and Treatment, edited by Jay D. Coffman, MD, and Robert T. Eberhardt, MD, 2003 Cardiac Repolarization: Bridging Basic and Clinical Science, edited by Ihor Gussak, MD, PhD, Charles Antzelevitch, PhD, Stephen C. Hammill, MD, Win K Shen, MD, and Preben Bjerregaard, MD, DMSc, 2003 Essentials of Bedside Cardiology: With a Complete Course in Heart Sounds and Murmurs on CD, Second Edition, by Jules Constant, MD, 2003 Primary Angioplasty in Acute Myocardial Infarction, edited by James E. Tcheng, MD, 2002

3 HEART DISEASE AND EREcnLE DYsFUNCIION Edited by ROBERT A. KLONER, MD, PhD Good Samaritan Hospital University of Southern California, Los Angeles, CA ~ HUMANA PRESS ~ TOTOWA, NEW JERSEY

4 2004 Humana Press Inc. Softcover reprint of the hardcover I st edition Riverview Drive. Suite 208 Totowa, New Jersey humanapress,com For additional copies, pricing for bulk purchases, and/or information about other Humana titles, contact Humana at the above address or at any of the following numbers: Tel.: ; Fax: , humana@humanapr.com; or visit our website: All rights reserved. No part ofthis book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. All articles, comments, opinions, conclusions, or recommendations are those of the author(s), and do not necessarily reflect the views of the publisher. Due diligence has been taken by the publishers, editors, and authors of this book to assure the accuracy of the information published and to describe generally accepted practices. The contributors herein have carefully checked to ensure that the drug selections and dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regulations, and knowledge from clinical experience relating to drug therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the treating physician to determine dosages and treatment strategies for individual patients. Further it is the responsibility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinical practice. The publisher, editors, and authors are not responsible for errors oromissions or for any consequences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. Production Editor: Mark J. Breaugh. Cover design by Patricia F. Cleary. This publication is printed on acid-free paper. G ANSI Z (American National Standards Institute) Permanence of Paper for Printed Library Materials. Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Humana Press Inc., provided that the base fee of US $25.00 per copy is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Humana Press Inc. The fee code for users of the Transactional Reporting Service is: [ /04 $25.00]. ISBN ISBN (ebook) DOI / Library of Congress Cataloging-in-Publication Data Heart disease and erectile dysfunction / edited by Robert A. Kloner. p. ; cm. -- (Contemporary cardiology) Includes bibliographical references and index. ISBN I. Impotence--Etiology.2. Coronary heart disease. 3. Sexual disorders--etiology. 4. Heart--Diseases. [DNLM: I. Impotence--etiology.2. Cardiovascular Diseases--complications. 3. Impotence--therapy. WJ 709 H ] I. Kloner, Robert A. II. Contemporary cardiology (Totowa, N.J.. Unnumbered) RC889.H ' dc

5 PREFACE Only a short time ago, if a man went to see his physician for erectile dysfunction (ED) he was often told that the problem was psychological. In the last lo-15 years there has been a growing appreciation of the concept that in men over the age of 50, one of the most common causes of ED is vascular. Vascular causes include endothelial dysfunction (the other ED, which is one of the earliest abnormalities in the spectrum of atherosclerosis) to full-blown obstructing atherosclerotic plaque. Since the key component of an erection is vasodilatation, if blood vessels cannot dilate normally owing to endothelial dysfunction, then a normal erection will not occur. Endothelial dysfunction will occur when the blood vessel is exposed to certain risk factors-hypertension, lipid abnormalities, cigaret smoking, diabetes, and others. It is therefore no surprise that these same risk factors for atherosclerotic cardiovascular disease are also risk factors for erectile dysfunction. Erectile dysfunction is a common problem in the cardiac patient. The purpose of Heart Disease and Erectile Dysfunction is to review the problem of erectile dysfunction from a cardiac standpoint. Chapters have been written by cardiologists, urologists, psychologists, pharmacologists, and basic scientists alike to synthesize the problem of erectile dysfunction as it relates to heart disease, review the physiology of ED, review the current therapies for ED and how they may interact with the cardiac system, review the potential application of the phosphodiesterase-5 inhibitors to cardiovascular disease, and review guidelines for dealing with the cardiac patient seeking help for ED. We hope that this is the first of many books that might help define a new subspecialty of "uro-cardiology" or "cardio-urology." I would like to thank Chris Cannon, MD, and Paul Dolgert for their encouragement in editing this text. I would also like to thank all of the contributing authors as well as my administrative assistant, Cathy Davisson, for help with typing and organizing the chapters. The drugs, indications for drugs, and drug dosages mayor may not be approved for general use by the Food and Drug Administration. Physicians should consult the package inserts and/or Physicians' Desk Reference for drug indications, contraindications, side effects, precautions, warnings, and dosages as recommended. v Robert A. Kloner, MD, PhD

6 CONTENTS Preface... v Contributors... ix 1 Physiology of Erection and Causes of Erectile Dysfunction... 1 Aristotelis G. Anastasiadis, Dmitry Droggin, Martin Burchardt, and Ridwan Shabsigh 2 Erectile Dysfunction: The Scope of the Problem Culley C. Carson 3 Erectile Dysfunction and Cardiovascular Risk Factors Robert A. Kloner 4 Psychologic Aspects of Erectile Dysfunction in Heart Patients Raymond C. Rosen 5 Management of Erectile Dysfunction: An Overview Harin Padma-Nathan 6 Sildenafil Citrate and the Nitric Oxide/Cyclic Guanosine Monophosphate Signaling Pathway Ian H. Osterloh and Stephen C. Phillips 7 Phosphodiesterase-5 Inhibition: Importance to the Cardiovascular System Jackie D. Corbin, Stephen R. Rannels, and Sharron H. Francis 8 The Hemodynamics of Phosphodiesterase-PDE5 Inhibitors Graham Jackson 9 Cardiovascular Safety of Phosphodiesterase-5 Inhibitors Robert A. Kloner VlI

7 Vlll Contents 10 Effect of Phosphodiesterase-5 Inhibition on Coronary Blood Flow in Experimental Animals YingJie Chen, Jay H. Traverse, and Robert J. Bache 11 Safety and Hemodynamic Effects of Sildenafil in Patients With Coronary Artery Disease Sameer Rohatgi and Howard C. Herrmann 12 Cardiovascular Effects of Nonphosphodiesterase-5 Inhibitor Erectile Dysfunction Therapies Harin Padma-Nathan 13 Potential Cardiac Applications of Phosphodiesterase Type-5 Inhibition Michael Sweeney and Richard L. Siegel 14 The Physiologic Cost of Sexual Activity Robert F. DeBusk 15 Sexual Activity As a Trigger of Myocardial InfarctionlIschemia: Implications for Treating Erectile Dysfunction Robert A. Kloner 16 Sex After Cardiac Events and Procedures: Counseling From the Cardiovascular Specialist's Perspective Herman A. Taylor, Jr. 17 American College of Cardiology/American Heart Association Guidelines on the Use of Sildenafil in Patients With Cardiovascular Disease Adolph M. Hutter, Jr. 18 Risk of Heart Attack After Sexual Activity: The Princeton Guidelines and Their Rationale Robert F. DeBusk Index

8 CONTRIBUTORS ARISTOTELIS G. ANASTASIADIS, MD, Department of Urology, College of Physicians and Surgeons, Columbia University, New York, NY ROBERT J. BACHE, MD, Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN MARTIN BURCHARDT, MD, Department of Urology, University of Dusseldorf, Dusseldorf, Germany CULLEY C. CARSON, MD, Division of Urology, University of North Carolina School of Medicine, Chapel Hill, NC YINGJIE CHEN, MD, PhD, Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN JACKIE D. CORBIN, PhD, Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN ROBERT F. DEBuSK, MD, Department of Medicine, Stanford University School of Medicine, Stanford, CA DMITRY DROGGIN, MD, Department of Urology, College of Physicians and Surgeons, Columbia University, New York, NY SHARRON H. FRANCIS, PhD, Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN HOWARD C. HERRMANN, MD, Cardiovascular Division, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA ADOLPH M. HUTTER, JR., MD, MACC, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA GRAHAM JACKSON, PRCP, FESC, FACC, FAHA, Cardiac Department, St. Thomas Hospital, London, UK ROBERT A. KLONER, MD, PhD, The Heart Institute, Good Samaritan Hospital, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA IAN H. OSTERLOH, MRCP, Pfizer Global Research and Development, Pfizer Ltd., Sandwich, Kent, UK HARIN PADMA-NATHAN, MD, The Male Clinic, Beverly Hills, CA; Division of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA ix

9 x Contributors STEPHEN C. PHILLIPS, PhD, Pfizer Global Research and Development, Pfizer Ltd., Sandwich, Kent, UK STEPHEN R. RANNELS, PhD, Department of Cell and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, PA SAMEER ROHATGI, MD, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, PA RAYMOND C. ROSEN, PhD, Departments of Psychiatry and Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ RIDWAN SHABSIGH, MD, Department of Urology, College of Physicians and Surgeons, Columbia University, New York, NY RICHARD L. SIEGEL, MD, US Pharmaceuticals Group, Pfizer Inc., New York, NY MICHAEL SWEENEY, MD, US Pharmaceuticals Group, Pfizer Inc., New York, NY HERMAN A. TAYLOR, JR., MD, FACC, FAHA, Department of Medicine, Jackson State University, University of Mississippi Medical Center, Jackson, MS JAY H. TRAVERSE, MD, Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN