Epicardial fat tissue can predict subclinical left ventricular dysfunction in patients with erectile dysfunction

Figures & data

Figure 1. Transthoracic echocardiography parasternal long-axis view demonstrating the epicardial fat tissue as the hypoechoic space on the right ventricular free wall at end-diastole.

Table 1. The baseline characteristics and laboratory findings of study patients.

Variables	Control (n:145)	ED (n = 129)	p Value
Age (years)	58.4 ± 7.5	59.5 ± 6.7	.621
Body mass index (kg/m^2)	23.2 ± 4.1	0.235 ± 4.6	.715
IEFF-5 score	0.23 ± 3.5	09.2 ± 2.5	<.001
HT, n(%)	65 (37.5)	60 (38.4)	.392
DM, n(%)	33 (19.1)	31 (19.8)	.467
Glucose (mg/dL)	115 ± 38	117 ± 35	.378
Family history of CAD, n(%)	23 (13.2)	21 (13.4)	.347
Smoking, n(%)	35 (20.2)	33 (21.1)	.694
Triglyceride (mg/dL)	182 ± 44	187 ± 51	.421
High-density lipoprotein (mg/dL)	38 ± 6	37 ± 7	.845
Low-density lipoprotein (mg/dL)	115 ± 41	127 ± 37	.031
Creatinine (mg/dL)	0.96 ± 0.14	0.98 ± 0.13	.345
Hemoglobin (mg/dL)	14.4 ± 1.7	13.8 ± 2.2	.112

CAD: coronary artery disease; DM: diabetes mellitus; ED: erectile dysfunction; HT: hypertension; IEFF-5: International Index of Erectile Function-5

Figure 2. The Spearman correlation analysis showed that a significant correlation was observed between EFT thickness and IIEF-5 score.

Table 2. The conventional echocardiographic findings of study patients.

Variables	Control (n:145)	ED (n = 129)	p Value
EFT (cm)	5.1 ± 2.0	7.8 ± 2.1	<.001
LVEF (%)	62.2 ± 3.7	63.1 ± 4.5	.271
LAd (cm)	3.75 ± 0.29	3.79 ± 0.33	.356
LVEDD (cm)	4.83 ± 0.32	4.79 ± 0.31	.234
LVESD (cm)	3.19 ± 0.21	3.21 ± 0.22	.423
PWd (cm)	0.92 ± 0.12	0.93 ± 0.10	.537
IVSd (cm)	0.96 ± 0.13	0.97 ± 0.11	.146
LVMI (g/m^2)	111.2 ± 21.6	112.3 ± 23.4	.324
E (m/s)	0.79 ± 0.16	0.76 ± 0.13	.254
A (m/s)	0.62 ± 0.11	0.65 ± 0.13	.121
E/A	1.22 ± 0.25	1.27 ± 0.29	.242
E/e’	6.8 ± 2.2	8.4 ± 2.6	.012

ED: erectile dysfunction; E/A: ratio between diastolic early (E) and late diastolic mitral inflow (A) velocities; E/e’: ratio between early diastolic mitral inflow velocity and early diastolic annular velocity; IVSd: interventricular septum thickness; LAd: Left atrial diameter; LVEDD: left ventricular end-diastolic diameter; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic diameter; LVMI: left ventricular mass index; PWd: posterior wall diastolic thickness

Table 3. The 2D speckle tracking echocardiographic findings of study patients.

Variables	Control (n = 145)	ED (n = 129)	p Value
GLS (%)	−21.1 ± 3.9	−18.2 ± 2.7	<.001
GCS (%)	−21.9 ± 3.9	−19.5 ± 4.1	<.001
Longitudinal SRs (1/s)	−1.81 ± 0.22	−1.33 ± 0.41	<.001
Longitudinal SRe (1/s)	1.59 ± 0.27	1.47 ± 0.31	.213
Longitudinal Sra (1/s)	1.23 ± 0.21	1.19 ± 0.23	.345
Circumferential SRs (1/s)	−1.72 ± 0.24	−1.41 ± 0.35	<.001
Circumferential Sre (1/s)	1.61 ± 0.29	1.53 ± 0.27	.412
Circumferential SRa (1/s)	1.33 ± 0.23	1.27 ± 0.26	.178

ED: erectile dysfunction; GCS: global circumferential strain; GLS: global longitudinal strain; SRa: diastolic strain rate during the late diastole; SRe: diastolic strain rate during the early diastole: SRs: systolic strain rate

Table 4. Independent predictors of LV-GLS in multiple linear regression analysis.

	Univariate analysis		Multivariate analysis
Variables	R	p Value	Β coefficient	95cl	p Value
EFT thickness	−0.504	<.001	−3.071	(−6.289)(−1.162)	<.001
Age	−0.463	.003	−0.973	(−1.711)(−0.175)	.017
LDL	−0.132	.125	–	–	.123
HT	−0.170	.004	−0.820	(−1.521)(−0.113)	.021
IIEF-5 score	0.513	<.001	1.746	(1.034)(3.143)	.003
E/e’	−0.214	.045	–	–	.243

EFT: epicardial fat tissue; E/e’: ratio between early diastolic mitral inflow velocity and early diastolic annular velocity; IIEF-5: International Index of Erectile Function-5, HT: hypertension; LDL: low-density lipoprotein; LV-GCS: global longitudinal strain

Table 5. Independent predictors of LV-GCS in multiple linear regression analysis.

	Univariate analysis		Multivariate analysis
Variables	R	p	Β coefficient	95cl	p Value
EFT thicknesss	−0.415	<.001	−3.413	(−5.375)( −1.479)	.004
Age	−0.363	.003	−0.145	(−0.259)( −0.075)	.021
LDL	−0.117	.151	–	–	.197
HT	−0.114	.012	–	–	.089
IIEF-5 score	0.524	<.001	1.098	(0.534)(2.454)	.023
E/e’	−0.325	.005	−0.756	(−1.789)( −0.197)	.003

EFT: epicardial fat tissue; E/e’: ratio between early diastolic mitral inflow velocity and early diastolic annular velocity; IIEF-5: International Index of Erectile Function-5; HT: hypertension; LDL: low-density lipoprotein; LV-GCS: global circumferential strain