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STATE-OF-THE-ART PAPER

Erectile Dysfunction in Heart Failure Patients

Ernst R. Schwarz, MD, PhD, FACC, FESC^_*,,_*, Saurabh Rastogi, MD, Vishal Kapur, MD, Nasir Sulemanjee, MD and Jennifer J. Rodriguez, MD

^_* Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, and the University of California, Los Angeles, Los Angeles, California
Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas

Manuscript received March 21, 2006; revised manuscript received April 26, 2006, accepted May 1, 2006.

^_* Reprint requests and correspondence: Dr. Ernst R. Schwarz, Department of Medicine, Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Suite 6215, Los Angeles, California 90048. (Email: ernst.schwarz{at}cshs.org).

Chronic heart failure (HF) and erectile dysfunction (ED) are 2 highly prevalent disorders that frequently occur concomitantly. Coronary artery disease, HF, and ED share several common risk factors, including diabetes mellitus, hypertension, smoking, and dyslipidemia. Additionally, the distinct physiologic sequelae of HF create unique organic and psychologic factors contributing to ED in this patient population. Standard HF therapy with beta-receptor blockers, digoxin and thiazide diuretics may worsen sexual dysfunction owing to medication side effects. This may, in turn, lead to noncompliance in misguided efforts to retain satisfactory sexual activity, with secondary worsening of cardiac capacity. This review describes the unique aspects of ED in the HF population.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   ARB = angiotensin-receptor blocker   CAD = coronary atherosclerotic disease   cGMP = cyclic guanosine monophosphate   ED = erectile dysfunction   HF = heart failure   NO = nitric oxide   NYHA = New York Heart Association   PDE-5 = phosphodiesterase-5

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