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European Heart Journal Advance Access published online on August 22, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl202
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received January 2, 2006
Revised July 27, 2006
Accepted August 4, 2006

Clinical research

Circulating endothelial progenitor cells correlate with erectile function in patients with coronary heart disease

Magnus Baumhäkel 1 *, Nikos Werner 2, Michael Böhm 1, and Georg Nickenig 2

1 Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, D-66421 Homburg/Saar, Germany
2 Medizinische Klinik II, Innere Medizin (Kardiologie, Pneumologie), Universitätsklinikum Bonn, Germany

* To whom correspondence should be addressed.
Magnus Baumhäkel, E-mail: magnus{at}baumhaekel.de


  Abstract

Aims The aim of the study was to determine the influence of endothelial progenitor cells (EPC) on erectile dysfunction (ED). EPC play a major role in repair mechanisms of the endothelial monolayer, but the role of EPC in ED is unclear.

Methods and results Circulating levels of CD34+/KDR+ and CD133+ EPC were determined in 119 patients with known coronary artery disease. ED was evaluated with an ED-score generated from the KEED questionnaire. Prevalence of ED was 59.7%. In univariate analysis, age, hypertension, reduced left ventricular ejection fraction (LVEF), diabetes, and circulating levels of CD133+ EPC, but not cardiovascular drug treatment were associated with ED. Body mass index (BMI) was positively (r = 0.319, P = 0.003) and high-density lipoprotein was negatively (r = - 0.246, P = 0.034) correlated with ED. Adjustment for age, diabetes, hypertension, BMI, smoking, LVEF, use of statins and lower urinary tract symptoms, and prior coronary intervention revealed low levels of circulating immature CD133+ EPC as independent risk factor for ED (95% CI -11.183 to -1.7371, P = 0.008).

Conclusion Reduced levels of circulating CD133+ EPC are an independent risk factor for ED. Thus, EPC may be a link between cardiovascular risk factors, endothelial dysfunction, and ED.

Keywords: Erectile dysfunction; Endothelial progenitor cell; EPC; Heart disease.
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