Parameters of nocturnal penile tumescence monitoring as potential predictors of the coronary heart disease

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Aim. To determine the possibilities of nocturnal penile tumescence (NPT) monitoring in the detection of coronary heart disease (CHD).

Materials and methods. A total of 100 patients were included in the study, of them 50 men had a confirmed diagnosis of CHD and 50 patients consisted the control group. In all patients, flow-dependent vasodilation of the brachial artery and pulse wave velocity were evaluated. The assessment of the quality of erection was carried out using IIEF-15 questionnaire (erectile domain) and Androscan NPT monitoring device. The relative increase in the diameter of the penis (rIn), the duration of NPT with rIn greater than or equal to 30% and 20%, respectively (dNPT with rIn≥30% and dNPT with rIn≥20%) were estimated.

Results. The age of the patients in both groups was comparable with a median of 58.0 years. Patients with CHD had a higher body mass index (BMI) than patients without CHD (29.2 kg/m2 vs. 26.9 kg/m2, respectively; p=0.011). In those without CHD, erectile function was better, both according to the IIEF-15 questionnaire and according to the monitoring of NPT. The model with the maximum coefficient of determination (R2 =32.1%) predicting the probability of having CHD included age, BMI, rIn and dNPT with rIn≥20%. The chance of having CHD increased by 10.5% and 1.6% with a decrease in rIn by 1% and a decrease in dNPT with rIn≥20% for 1 minute. The sensitivity and specificity of the model was 74% and 65.3%, respectively.

Conclusion. Monitoring of the NPT is an important tool for the diagnosis of vascular ED. Based on the results, it is possible to assess the probability of CHD. In contrast to the IIEF-15 questionnaire, NPT, dNPT with rIn≥20% and rIn are more likely to suggest the presence of CHD. The lower the OP and dNPT with rIn ≥20%, the higher the probability of having CHD.

Sobre autores

A. Kamalov

Lomonosov Moscow State University

Email: armais.kamalov@rambler.ru
ORCID ID: 0000-0003-4251-7545

PhD, MD, Professor, Academician of the RAS, Director of the Medical Research and Educational Center, Head of the Department of Urology and Andrology, Faculty of Fundamental Medicine

Rússia, Moscow

Ya. Orlova

Lomonosov Moscow State University

Email: YAOrlova@mc.msu.ru
ORCID ID: 0000-0002-8160-5612

Ph.D., MD, Professor, Leading Researcher at the Department of Urology and Andrology of Medical Scientific and Educational Center, Head of the Department of Internal Medicine, Faculty of Fundamental Medicine

Rússia, Moscow

M. Chalyi

Lomonosov Moscow State University

Email: chalyy@bk.ru
ORCID ID: 0000-0003-1736-9085

PhD, MD, Professor, Leading Researcher at the Department of Urology and Andrology of Medical Scientific and Educational Center

Rússia, Moscow

D. Okhobotov

Lomonosov Moscow State University

Email: 14072003m@mail.ru
ORCID ID: 0000-0002-6768-9004

PhD, MD, Urologist, Researcher at the Department of Urology and Andrology of Medical Scientific and Educational Center, Associate Professor at the Department of Urology and Andrology of Faculty of Fundamental Medicine

Rússia, Moscow

A. Strigunov

Lomonosov Moscow State University

Email: an-strigunov@yandex.ru
ORCID ID: 0000-0003-4518-634X

Urologist, Trainee Researcher at the Department of Urology and Andrology, Medical Scientific and Educational Center

Rússia, Moscow

O. Nesterova

Lomonosov Moscow State University

Autor responsável pela correspondência
Email: oy.nesterova@gmail.com
ORCID ID: 0000-0003-3355-4547

PhD, Urologist, Researcher at the Department of Urology and Andrology at the Medical Scientific and Educational Center, Senior Tutor of the Department of Urology and Andrology of Faculty of Fundamental Medicine

Rússia, Moscow

E. Makeeva

Russian University of Medicine

Email: makeevazhenia672@gmail.com
ORCID ID: 0009-0001-0485-632X

6th-Year Student of the Semashko Institute of Clinical Medicine

Rússia, Moscow

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2. Fig. 1. Comparison of basic indices of patients with presence of CHD (1) and absence of CHD (0): A - body mass index (BMI), B - duration of nocturnal penile tumescence with a relative increase greater than or equal to 30% of the baseline value (dNPT with OP>30%), C - duration of nocturnal penile tumescence with a relative increase greater than or equal to 20% of the baseline value (dNPT with OP>20%), D - relative increase in penile diameter (DD), E - MIEF-15 scores (erectile domain)

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3. Fig. 2. ROC-analysis for the model including classical risk factors and parameters of nocturnal penile thromescence monitoring: A - ROC curve, B - intersection of sensitivity and specificity curves at the selected cut-off point of 0.5 (50% probability of CHD)

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