Aerobic physical activity improves endothelial function in the middle-aged patients with erectile dysfunction

Figures & data

Table I. Protocol of aerobic physical activity and Mediterranean diet's principles observed by patients during the study.

Detection of target heart rate according to Karvonen's formula [22]:

Frequency of cardiac reserve (FCR) = Maximum heart rate – Basal cardiac frequency

More generally: THR = (Maximum heart rate* – basal cardiac frequency) × % Intensity) + basal cardiac frequency, where: intensity = 70–80% for aerobic work

Doses of activity: 150 min of moderate intensity aerobic activity per week

Duration of bouts: 30 min

Practical advice: All patients practiced physical activity with heart rate training between 40 and 60% of maximum heart rate.

Principles of the traditional Mediterranean diet observed during the study [23]:

1. High ratio of monounsaturated to saturated dietary lipids (mainly olive oil)

2. Moderate ethanol consumption

3. High consumption of legumes

4. High consumption of non-refined cereals, including bread

5. High consumption of fruits

6. High consumption of vegetables

7. Low consumption of meat and meat products

8. Moderate consumption of milk and dairy products

Figure 1. Representative flow cytometric scattergrams showing the gating strategy used. Upper panels, after PhA standard aerobic protocol in patients with ED; lower panels, before PhA aerobic protocol. Both histograms 1 report the forward versus side scatter dot plot: three different cell populations can be identified (gate F: lymphocytes; gate I: monocytes; gate J: polymorphonuclear cells). Both histograms 2 report the CD45_pos (E) and CD45_neg (G) cells. Both histograms 3 report only the CD45_neg cells (gate G) subdivided according to the expression of CD34 and CD144 antigen staining. EPCs were defined as CD45_neg/CD34_pos/CD144_pos, whereas EMP CD45_neg/CD34_neg/CD144_pos.

Table II. Penile dynamic echo-color doppler parameters, IIEF-5 score and metabolic features (mean ± SEM) of the patients (group A and group B) with arterial erectile dysfunction at baseline and after three months of standard aerobic protocol of physical activity.

Parameters	Group A baseline	Group B baseline	Group A after 3 months	Group B after 3 months
Peak systolic velocity (cm/s)	27.0 ± 0.5	27.5 ± 1.2	33.3 ± 1.0*^†	28.0 ± 1.0
EDV (cm/s)	2.0 ± 0.5	2.0 ± 1.8	1.5 ± 0.5	1.5 ± 1.0
Acceleration time (ms)	127.2 ± 1.2	129.3 ± 1.6	112.1 ± 1.0*^†	128.2 ± 1.2
Resistance index	0.91 ± 0.03	0.92 ± 0.01	0.93 ± 0.08	0.91 ± 0.01
Intima-media thickness (mm)	0.33 ± 0.02	0.34 ± 0.04	0.32 ± 0.02	0.35 ± 0.04
IIEF-5	11.0 ± 1.0	10.5 ± 0.7	16.5 ± 1.0*^†	11.0 ± 0.7
Serum T concentration (ng/dl)	436 ± 12.2	452 ± 15.0	450 ± 15.2	453 ± 20.0
Body mass index (kg/m^2)	27.5 ± 1.0	27.9 ± 1.2	26.0 ± 0.5*^†	27.7 ± 1.0
Total cholesterol (mg/dl)	213.1 ± 13.1	218.0 ± 11.2	116.1 ± 10.1*^†	216.0 ± 11.2
HDL cholesterol (mg/dl)	43.0 ± 3.3	42.0 ± 0.7	38.0 ± 2.2*^†	41.0 ± 1.7
Triglycerides (mg/dl)	189.1 ± 10.1	194.0 ± 17.2	121.1 ± 10.2*^†	190.0 ± 17.2
Systolic blood pressure (mmHg)	143.4 ± 7.1	142.4 ± 11.2	134.2 ± 5.1*^†	141.2 ± 11.2
Diastolic blood pressure (mmHg)	94.1 ± 7.4	92.5 ± 6.2	87.5 ± 8.4*^†	92.5 ± 6.2

*p < 0.05 compared to group A at baseline.^†p < 0.05 compared to group B after 3 months.

Figure 2. Percentage of circulating endothelial progenitor cells (immunophenotype CD45_neg/CD34_pos/CD144_pos) and percentage of circulating endothelial microparticles (immunophenotype CD45_neg/CD34_neg/CD144_pos) in all patients with ED at baseline (group A compared to group B).

Figure 3. Percentage of circulating endothelial progenitor cells (immunophenotype CD45_neg/CD34_pos/CD144_pos) and percentage of circulating endothelial microparticles (immunophenotype CD45_neg/CD34_neg/CD144_pos) in all patients with ED after 3 months of PhA standard aerobic protocol (group A compared to group B).