Deterioration of heart rate recovery index in patients with erectile dysfunction

OBJECTIVE Heart rate recovery (HHR) after exercise is a function of vagal reactivation. This study aimed to evaluate HHR index in patients with erectile dysfunction. METHODS Men over the age of 18 years who were diagnosed with erectile dysfunction were included in the study. Ninety patients with erectile dysfunction (mean age=56.1±8.3 years) and 50 healthy subjects as controls (mean age=53.1±10.4 years) were compared. The erectile status of patients was evaluated using the sexual health inventory for men questionnaire. Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients and controls. The HHR index was defined as the reduction in heart rate from the rate at peak exercise to the rate at the first minute (HRR1), second minute (HRR2), third minute (HRR3), and fifth minute (HRR5) after terminating exercise stress testing. An independent sample t-test, Pearson correlation coefficient test, linear multivariate regression analysis, and receiver operating characteristic curve analysis were used for statistical assessment. RESULTS All HHR indices were found to be significantly decreased in patients with erectile dysfunction (p<0.001). Effort capacity was markedly lower (9.1±2.3 vs. 10.4±2.3 METs, p=0.002) among patients with erectile dysfunction. HRR1 and HRR3 were found to be an independent risk factor for erectile dysfunction (Beta=0.462, p<0.001; Beta=0.403, p<0.001; respectively) in linear regression analysis. CONCLUSION Decreased HHR index may be considered as one of the independent predictors of impaired autonomic function in patients with erectile dysfunction.