AUTONOMIC-SYMPATHETIC HYPERACTIVITY (AH) AND ERECTILE DYSFUNCTION

这个子项目是众多研究子项目之一

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The Metabolic Syndrome (MESY) has gained recent attention due to its increasing prevalence in the US (23.7%), where it affects over 47 million people. It is thought to have great socioeconomic cost because of its association with non-insulin dependent diabetes mellitus (DM), hypertension (HTN), dyslipidemia (DYS), autonomic-sympathetic hyperactivity (AH) and cardiovascular disease (CVD). Pathophysiologic investigations blame two key components in the etiology of MESY: 1) systemic inflammation (elevated C-reactive protein (CRP)) and 2) autonomic-sympathetic hyperactivity (AH). MESY is an emerging "risk factor" for erectile dysfunction (ED) as many of the abnormalities are themselves independent risk factors for ED (i.e. DM, HTN, DYS, and CVD). AH, as a component of MESY has a well established relationship with the development of HTN, insulin resistance and DYS. A relationship between AH and Lower Urinary Tract Symptoms (LUTS) has been established, additionally it has been hypothesized that AH may be one of the crucial pathophysiologic mechanisms linking ED with LUTS. The relationship between ED and AH is completely uninvestigated even though all other aspects of the MESY are key factors for ED. We now hypothesize that AH is a crucial and unrecognized etiologic factor in the development of ED and it has a casual relationship in symptomatic progression. To test this hypothesis, we propose to make an assessment of the functional state of the autonomic nervous system in ED patients. We propose to carry out a series of non-invasive assessments that reflect sympathetic function and correlate them with ED and penile arterial flow measurements. We hypothesize that men with ED will have a linear relationship between ED severity and increasing level of AH. The proposed study is a single site clinical investigation in which men with ED will undergo a series of non-invasive studies to document the level of autonomic tone, autonomic reactivity to circulatory stress, penile blood flow, ED risk factor profiling and evaluation.