Abstract：
Erectile dysfunction (ED) is associated with an increased risk of cardiovascular morbidity and mortality.
To systematically review and analyze the cardiac structure and function in men with ED assessed with echocardiography.
We performed a systematic review and meta-analysis according to the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-analyses. We searched PubMed and the Cochrane Library on June 2, 2022, and included studies evaluating cardiac structure and function using echocardiography in men with ED compared with controls without ED. The Newcastle-Ottawa Quality Assessment Scale was used for assessing the quality of studies. We analyzed the mean differences in left ventricular ejection fraction (LVEF), the ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/e\'), ratio of the early to late diastolic transmitral flow velocity (E/A), isovolumic relaxation time (IVRT), and left ventricular mass index (LVMi) in a random-effect model computed using means and standard deviations. The review was preregistered with PROSPERO (CRD42022337183). We received no funding.
We included ten studies with 763 men diagnosed with ED (mean age: 55.6 yr) and 358 control men (mean age: 54.4 yr). E/e\' was significantly worse in men with ED than in controls (mean absolute difference = 1.17, 95% confidence interval or CI [0.68, 1.65], p < 0.005). No significant differences were observed in LVEF, E/A, IVRT, or LVMi (-0.06, 95% CI [-1.06, 0.95], p = 0.91; -0.06, 95% CI [-0.24, 0.13], p = 0.55; 11.76, 95% CI [-0.88, 24.39], p = 0.07; and 4.37, 95% CI [-2.91, 11.65], respectively). The studies exhibited heterogeneity regarding study populations, reported echocardiography data, and variations in adjustments for confounding factors.
Left ventricle diastolic dysfunction, as assessed by E/e\', was more frequent in men with ED than in matched controls without ED. The results imply that echocardiography may be useful in the cardiovascular evaluation of men with ED to help identify myocardial impairment.
This study reviewed for the first time previous research on cardiac structure and function in men with erectile dysfunction (ED), as assessed by echocardiography. We found that men with ED, compared with men without ED, had a higher ratio of early transmitral filling velocity to early diastolic mitral annular velocity , indicating a potentially higher rate of impaired diastolic function-a potential early indicator of heart disease. Identification of early signs of heart problems in men with ED may help initiate necessary lifestyle modifications or preventative therapies before the development of heart disease. However, more research is required to determine the clinical utility of using echocardiography as a risk assessment method.
To systematically review and analyze the cardiac structure and function in men with ED assessed with echocardiography.
We performed a systematic review and meta-analysis according to the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-analyses. We searched PubMed and the Cochrane Library on June 2, 2022, and included studies evaluating cardiac structure and function using echocardiography in men with ED compared with controls without ED. The Newcastle-Ottawa Quality Assessment Scale was used for assessing the quality of studies. We analyzed the mean differences in left ventricular ejection fraction (LVEF), the ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/e\'), ratio of the early to late diastolic transmitral flow velocity (E/A), isovolumic relaxation time (IVRT), and left ventricular mass index (LVMi) in a random-effect model computed using means and standard deviations. The review was preregistered with PROSPERO (CRD42022337183). We received no funding.
We included ten studies with 763 men diagnosed with ED (mean age: 55.6 yr) and 358 control men (mean age: 54.4 yr). E/e\' was significantly worse in men with ED than in controls (mean absolute difference = 1.17, 95% confidence interval or CI [0.68, 1.65], p < 0.005). No significant differences were observed in LVEF, E/A, IVRT, or LVMi (-0.06, 95% CI [-1.06, 0.95], p = 0.91; -0.06, 95% CI [-0.24, 0.13], p = 0.55; 11.76, 95% CI [-0.88, 24.39], p = 0.07; and 4.37, 95% CI [-2.91, 11.65], respectively). The studies exhibited heterogeneity regarding study populations, reported echocardiography data, and variations in adjustments for confounding factors.
Left ventricle diastolic dysfunction, as assessed by E/e\', was more frequent in men with ED than in matched controls without ED. The results imply that echocardiography may be useful in the cardiovascular evaluation of men with ED to help identify myocardial impairment.
This study reviewed for the first time previous research on cardiac structure and function in men with erectile dysfunction (ED), as assessed by echocardiography. We found that men with ED, compared with men without ED, had a higher ratio of early transmitral filling velocity to early diastolic mitral annular velocity , indicating a potentially higher rate of impaired diastolic function-a potential early indicator of heart disease. Identification of early signs of heart problems in men with ED may help initiate necessary lifestyle modifications or preventative therapies before the development of heart disease. However, more research is required to determine the clinical utility of using echocardiography as a risk assessment method.
摘要：
背景：勃起功能障碍（ED）与心血管疾病发病率和死亡率的风险增加有关。
目的：系统评价和分析男性ED患者的心脏结构和功能。
方法：我们根据系统评价和荟萃分析的首选报告项目指南进行了系统评价和荟萃分析。我们于2022年6月2日搜索了PubMed和Cochrane图书馆，并纳入了使用超声心动图评估ED男性与没有ED的对照组的心脏结构和功能的研究。纽卡斯尔-渥太华质量评估量表用于评估研究质量。我们分析了左心室射血分数（LVEF）的平均差异，早期二尖瓣充盈速度与早期舒张二尖瓣环速度之比(E/E')，舒张早期和晚期的血流速度比（E/A），等容弛豫时间（IVRT），和使用均值和标准偏差计算的随机效应模型中的左心室质量指数（LVMi）。该审查已在PROSPERO（CRD42022337183）预注册。我们没有收到任何资金。
结果：我们纳入了10项研究，其中763名诊断为ED的男性（平均年龄：55.6岁）和358名对照男性（平均年龄：54.4岁）。与对照组相比，男性ED患者的E/e明显更差（平均绝对差异=1.17，95％置信区间或CI[0.68，1.65]，p<0.005)。LVEF无显著差异,E/A,IVRT,或LVMi（-0.06，95%CI[-1.06，0.95]，p=0.91；-0.06，95%CI[-0.24，0.13]，p=0.55；11.76，95%CI[-0.88，24.39]，p=0.07；和4.37，95%CI[-2.91，11.65]，分别)。这些研究表现出关于研究人群的异质性，报告的超声心动图数据，以及混杂因素调整的变化。
结论：左心室舒张功能不全，由E/E评估，与没有ED的配对对照组相比，患有ED的男性更频繁。结果表明，超声心动图可用于ED男性的心血管评估，以帮助识别心肌损害。
结果：这项研究首次回顾了先前关于勃起功能障碍（ED）男性心脏结构和功能的研究，通过超声心动图评估。我们发现有ED的男人，与没有ED的男性相比，早期二尖瓣充盈速度与早期舒张二尖瓣环速度之比较高，表明舒张功能受损的潜在发生率可能较高，这是心脏病的潜在早期指标。在患有ED的男性中识别心脏问题的早期迹象可能有助于在心脏病发展之前启动必要的生活方式改变或预防性治疗。然而,需要更多的研究来确定使用超声心动图作为风险评估方法的临床实用性.
目的：系统评价和分析男性ED患者的心脏结构和功能。
方法：我们根据系统评价和荟萃分析的首选报告项目指南进行了系统评价和荟萃分析。我们于2022年6月2日搜索了PubMed和Cochrane图书馆，并纳入了使用超声心动图评估ED男性与没有ED的对照组的心脏结构和功能的研究。纽卡斯尔-渥太华质量评估量表用于评估研究质量。我们分析了左心室射血分数（LVEF）的平均差异，早期二尖瓣充盈速度与早期舒张二尖瓣环速度之比(E/E')，舒张早期和晚期的血流速度比（E/A），等容弛豫时间（IVRT），和使用均值和标准偏差计算的随机效应模型中的左心室质量指数（LVMi）。该审查已在PROSPERO（CRD42022337183）预注册。我们没有收到任何资金。
结果：我们纳入了10项研究，其中763名诊断为ED的男性（平均年龄：55.6岁）和358名对照男性（平均年龄：54.4岁）。与对照组相比，男性ED患者的E/e明显更差（平均绝对差异=1.17，95％置信区间或CI[0.68，1.65]，p<0.005)。LVEF无显著差异,E/A,IVRT,或LVMi（-0.06，95%CI[-1.06，0.95]，p=0.91；-0.06，95%CI[-0.24，0.13]，p=0.55；11.76，95%CI[-0.88，24.39]，p=0.07；和4.37，95%CI[-2.91，11.65]，分别)。这些研究表现出关于研究人群的异质性，报告的超声心动图数据，以及混杂因素调整的变化。
结论：左心室舒张功能不全，由E/E评估，与没有ED的配对对照组相比，患有ED的男性更频繁。结果表明，超声心动图可用于ED男性的心血管评估，以帮助识别心肌损害。
结果：这项研究首次回顾了先前关于勃起功能障碍（ED）男性心脏结构和功能的研究，通过超声心动图评估。我们发现有ED的男人，与没有ED的男性相比，早期二尖瓣充盈速度与早期舒张二尖瓣环速度之比较高，表明舒张功能受损的潜在发生率可能较高，这是心脏病的潜在早期指标。在患有ED的男性中识别心脏问题的早期迹象可能有助于在心脏病发展之前启动必要的生活方式改变或预防性治疗。然而,需要更多的研究来确定使用超声心动图作为风险评估方法的临床实用性.
