Evaluation of ventricular repolarization parameters in erectile dysfunction: a predictor of cardiac diseases
1Department of Cardiology, Bilecik Seyh Edebali University Faculty of Medicine, 11230 Bilecik, Turkey
2Department of Urology, Bilecik Education and Training Hospital, 11230 Bilecik, Turkey
3Department of Cardiology, Ankara Education and Training Hospital, 06080 Ankara, Turkey
4Department of Bioengineering, Bilecik Seyh Edebali University, 11230 Bilecik, Turkey
DOI: 10.31083/j.jomh1803078 Vol.18,Issue 3,March 2022 pp.1-7
Submitted: 12 December 2021 Accepted: 02 February 2022
Published: 31 March 2022
*Corresponding Author(s): İsa Ardahanlı E-mail: firstname.lastname@example.org
Background: The purpose of this study is to compare the electrocardiogram (ECG) parameters, which are indicators of ventricular repo-larization, between men with erectile dysfunction (ED) and healthy ones. Methods: A total of 56 men aged 30–65 years diagnosed with ED were included in the study from March 2021 to November 2021. The control group comprises 59 year-old healthy male volunteers. The International Index of Erectile Function (IIEF-5) questionnaires were used to diagnose ED. The standard 12-lead surface ECG was taken for the whole study group and QT intervals (time between start of the Q, and end of the T wave seen on an ECG, approximating to the time taken from when the cardiac ventricles start to contract to when they finish relaxing), QRS complex (a combination of Q, R, and S waves seen on a typical ECG), and Tp-e intervals (the interval from the peak to the end of the electrocardiographic T wave seen on an ECG) were measured. The corrected QT (QTc) was calculated according to the heart rate using Bazett’s formula. The Tp-e/QT and Tp-e/QTc ratios were calculated. Results: The mean age in the study group was 51.88 years ± 1.13 years. Comorbid conditions were similar between the ED and control groups. There was no significant difference between the ECG parameters of the groups (i.e., heart rate, RR interval, QT, QTc and QRS duration). However, the Tp-e interval (76.79 ms ± 1.41 ms vs 70.46 ms ± 1.27 ms, p = 0.0006), Tp-e/QT (0.21 ± 0.004 vs 0.19 ± 0.004, p = 0.0054) and Tp-e/QTc (0.21 ± 0.004 vs 0.17 ± 0.004, p < 0.0001) was significantly higher in the ED group than in the healthy control group. Conclusions: The routine cardiac evaluation in cases of a disease knowingly related to cardiovascular diseases, such as ED, provides an opportunity to anticipate possible complications and take precautions. We believe that an inexpensive and non-invasive method such as the ECG is important in this cardiac evaluation. The use of relatively new parameters in routine ECG evaluation such as Tp-e and Tp-e/QT, which show the transmural distribution of repolarization, may also be useful in estimating the risk of arrhythmia.
Tp-e interval; Tp-e/QT; Tp-e/QTc; erectile dysfunction; arrhythmia
İsa Ardahanlı,Ali Haydar Yılmaz,Onur Akgün,Rafig Gurbanov. Evaluation of ventricular repolarization parameters in erectile dysfunction: a predictor of cardiac diseases. Journal of Men's Health. 2022. 18(3);1-7.
 McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Lau-mann E, et al. Definitions of Sexual Dysfunctions in Women and Men: a Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. The Journal of Sexual Medicine. 2016; 13: 135–143.
 De Tejada IS, Angulo J, Cellek S, González‐Cadavid N, Heaton J, Pickard R, et al. Pathophysiology of Erectile Dysfunction. The Journal of Sexual Medicine. 2005; 2: 26–39.
 Pascual-Regueiro N, Baleriola-Júlvez JM, Hortelano-Perales M, Panach-Navarrete J, Casco-Sales L, Martínez-Jabaloyas JM. Erectile dysfunction: Prevalence and its relationship with lower urinary tract symptoms. Medicina ClíNica. 2020; 154: 440–443.
 Miner M, Parish SJ, Billups KL, Paulos M, Sigman M, Blaha MJ. Erectile Dysfunction and Subclinical Cardiovascular Dis-ease. Sexual Medicine Reviews. 2019; 7: 455–463.
 Sangiorgi G, Cereda A, Benedetto D, Bonanni M, Chiricolo G, Cota L, et al. Anatomy, Pathophysiology, Molecular Mech-anisms, and Clinical Management of Erectile Dysfunction in Patients Affected by Coronary Artery Disease: A Review. Biomedicines 2021; 9: 432.
 Corona G, Rastrelli G, Isidori A, Pivonello R, Bettocchi C, Reis-man Y, et al. Erectile dysfunction and cardiovascular risk: a re-view of current findings. Expert Review of Cardiovascular Ther-apy. 2020; 18: 155–164.
 Zegard A, Okafor O, Debono J, Kalla M, Lencioni M, Marshall H, et al. Myocardial fibrosis as a predictor of sudden death in patients with coronary artery disease. EP Europace. 2021; 77: 29–41.
 Arteyeva NV. Dispersion of ventricular repolarization: Temporal and spatial. World Journal of Cardiology. 2020; 12: 437–449.
 Luo JY, He PK, Yan GX, Wu L. Differential diagnosis and man-agements of torsades de pointes and polymorphic ventricular tachycardia. Zhonghua Xin Xue Guan Bing Za Zhi. 2020; 48: 168–72. (In Chinese)
 Antzelevitch C, Sicouri S, Di Diego JM, Burashnikov A, Viskin S, Shimizu W, et al. Does Tpeak-Tend provide an index of trans-mural dispersion of repolarization? Heart Rhythm. 2007; 4: 1114–1116.
 Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. Journal of Electro-cardiology. 2008; 41: 575–580.
 Çakici M, Çetin M, Polat M, Süner A. Takotsubo sendromu ile ilişkili uzun QT’nin tetiklediǧi ventrikül taşikardisi. Turk Kardiy-oloji Dernegi Arsivi. 2014; 42: 71–75.
 Couderc J. Measurement and regulation of cardiac ventricular repolarization: from the QT interval to repolarization morphol-ogy. Philosophical Transactions of the Royal Society a: Mathe-matical, Physical and Engineering Sciences. 2009; 367: 1283–1299.
 Castiglione A, Odening K. QT-Zeit – was fange ich eigentlich damit an? DMW - Deutsche Medizinische Wochenschrift. 2020; 145: 536–542.
 Locati ET, Bagliani G, Padeletti L. Normal Ventricular Repolar-ization and QT Interval: Ionic Background, Modifiers, and Mea-surements. Cardiac Electrophysiology Clinics. 2017; 9: 487–513.
 Tse G, Gong M, Wong WT, Georgopoulos S, Letsas KP, Vas-siliou VS, et al. The Tpeak - Tend interval as an electrocardio-graphic risk marker of arrhythmic and mortality outcomes: a systematic review and meta-analysis. Heart Rhythm. 2017; 14: 1131–1137.
 Chua KCM, Rusinaru C, Reinier K, Uy-Evanado A, Chugh H, Gunson K, et al. Tpeak-to-Tend interval corrected for heart rate: a more precise measure of increased sudden death risk? Heart Rhythm. 2016; 13: 2181–2185.
 Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. Jour-nal of Electrocardiology. 2008; 41: 567–574.
 Yontar OC, Karaagac K, Tenekecioglu E, Tutuncu A, Demir M, Melek M. Assessment of ventricular repolarization inhomo-geneity in patients with mitral valve prolapse: value of T wave peak to end interval. International Journal of Clinical and Exper-imental Medicine. 2014; 7: 2173–2178.
 Braschi A, Frasheri A, Lombardo RM, Abrignani MG, Lo Presti R, Vinci D, et al. Association between Tpeak-Tend/QT and ma-jor adverse cardiovascular events in patients with Takotsubo syndrome. Acta Cardiologica. 2021; 76: 732–738.
 Ardahanli I, Celik M. Comparison of Tp-e interval, QTc inter-val and Tp-e/QTc ratios between non-diabetic and prediabetic population. Annals of Medical Research. 2020; 27: 3117–3122.
 Román-Guzmán R M, Joya-Harrison J A, Navarrete-López C A, et al. Shortening in the Tp-e/QTc ratio after angioplasty in patients with acute coronary syndrome. Archivos de Cardiología de México. 2020; 90: 416–430.
 Lee S, Zhou J, Liu T, Letsas KP, Hothi SS, Vassiliou VS, et al. Temporal Variability in Electrocardiographic Indices in Subjects With Brugada Patterns. Frontiers in Physiology. 2020; 11: 953.
 Avci A, Acehan S, Avci BS, Gulen M, Bulut A, Satar S. QTc, Tp-e interval and Tp-e/QTc ratio in patients with nontraumatic subarachnoid hemorrhage. The American Journal of Emergency Medicine. 2020; 38: 2458–2459.
 Demirtaş K, Yayla Ç, Yüksel M, Açar B, Ünal S, Ertem AG, et al. Tp-e interval and Tp-e/QT ratio in patients with celiac dis-ease. Revista Clinica Espanola. 2017; 217: 439–445.
 Ardahanli I, Akyuz O. The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiog-raphy. Selcuk Tip Dergisi. 2021; 37: 5–10.
 Okutucu S, Karakulak UN, Aksoy H, Sabanoglu C, Hekimsoy V, Sahiner L, et al. Prolonged Tp-e interval and Tp-e/Qt correlates well with modified Rodnan skin severity score in patients with systemic sclerosis. Cardiology Journal. 2016; 23: 242–249.
 Yayla Ç, Bilgin M, Akboğa MK, Gayretli Yayla K, Canpolat U, Dinç Asarcikli L, et al. Evaluation of Tp-E Interval and Tp-E/QT Ratio in Patients with Aortic Stenosis. Annals of Noninvasive Electrocardiology. 2016; 21: 287–293.
 Diaconu CC, Manea M, Marcu DR, Socea B, Spinu AD, Bratu OG. The erectile dysfunction as a marker of cardiovascular dis-ease: a review. Acta Cardiologica. 2020; 75: 286–292.
 Ip M, Diamantakos E, Haptonstall K, Choroomi Y, Moheimani RS, Nguyen KH, et al. Tobacco and electronic cigarettes ad-versely impact ECG indexes of ventricular repolarization: im-plication for sudden death risk. American Journal of Physiology-Heart and Circulatory Physiology. 2020; 318: H1176–H1184.
 Ardahanli I, TURAN Y, Turan E, et al. Evaluation of the my-ocardial performance ındex in prediabetic patients. Cumhuriyet Medical Journal. 2019; 41: 348–356.
 Tanaka Y, Bundy JD, Allen NB, Uddin SMI, Feldman DI, Mi-chos ED, et al. Association of Erectile Dysfunction with Inci-dent Atrial Fibrillation: the Multi-Ethnic Study of Atheroscle-rosis (MESA). The American Journal of Medicine. 2020; 133: 613–620.e1.
 Yılmaz S, Kuyumcu MS, Akboga MK, Sen F, Balcı KG, Balcı MM, et al. The relationship between erectile dysfunction and paroxysmal lone atrial fibrillation. Journal of Interventional Car-diac Electrophysiology. 2016; 46: 245–251.
 Altunkol A, Topuz AN, Genç Ö, Alma E, Topuz M. Atrial elec-tromechanical duration prolongs in patients with erectile dys-function. The Aging Male. 2020; 23: 154–160.
 Hajian-Tilaki K. Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation. Caspian Journal of Internal Medicine. 2014; 4: 627–635.
 Mandrekar JN. Receiver operating characteristic curve in diag-nostic test assessment. Journal of Thoracic Oncology. 2010; 5: 1315–1316.
 Costa S, Saguner AM, Gasperetti A, Akdis D, Brunckhorst C, Duru F. The Link Between Sex Hormones and Susceptibility to Cardiac Arrhythmias: From Molecular Basis to Clinical Impli-cations. Frontiers in Cardiovascular Medicine. 2021; 8: 85.
 Piccirillo G, Moscucci F, Pofi R, D’Alessandro G, Minnetti M, Isidori AM, et al. Changes in left ventricular repolariza-tion after short-term testosterone replacement therapy in hypog-onadal males. Journal of Endocrinological Investigation. 2019; 42: 1051–1065.
 Giannini F, Toselli M, Palmisano A, Cereda A, Vignale D, Leone R, et al. Coronary and total thoracic calcium scores predict mor-tality and provides pathophysiologic insights in COVID-19 pa-tients. Journal of Cardiovascular Computed Tomography. 2021; 15: 421–430.
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