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A Home-Based Walking Program Improves Erectile Dysfunction in Men With an Acute Myocardial Infarction

Published:December 17, 2014DOI:https://doi.org/10.1016/j.amjcard.2014.12.007
      The purpose of this study was to evaluate the influence of a home-based walking program on erectile function and the relation between functional capacity and erectile dysfunction (ED) in patients with recent myocardial infarctions. Patients with acute myocardial infarctions deemed to be at low cardiovascular risk were randomized into 2 groups: (1) a home-based walking group (n = 41), instructed to participate in a progressive outdoor walking program, and (2) a control group (n = 45), receiving usual care. Functional capacity was determined by the 6-minute walk test and evaluation of sexual function by the International Index of Erectile Function questionnaire; the 2 tests were performed at hospital discharge and 30 days later. In the overall cohort, 84% of patients reported previous ED at hospital discharge. After 30 days, ED had increased by 9% in the control group in relation to baseline (p = 0.08). However, the home-based walking group had a significant decrease of 71% in reported ED (p <0.0001). The 6-minute walk distance was statistically significant higher in the home-based walking group compared with the control group (p = 0.01). There was a significant negative correlation between 6-minute walk distance and ED 30 days after hospital discharge (r = −0.71, p <0.01). In conclusion, an unsupervised home-based progressive walking program led to significant improvements in functional capacity in men at low cardiovascular risk after recent acute myocardial infarctions. In addition, this intervention demonstrated a link between functional capacity and exercise training and erectile function improvement.
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      References

        • Kałka D.
        • Domagała Z.
        • Dworak J.
        • Womperski K.
        • Rusiecki L.
        • Marciniak W.
        • Adamus J.
        • Pilecki W.
        Association between physical exercise and quality of erection in men with ischaemic heart disease and erectile dysfunction subjected to physical training.
        Kardiol Pol. 2013; 71: 573-580
        • American Thoracic Society
        Standardization of spirometry, 1994 update.
        Am J Respir Crit Care Med. 1995; 152: 1107-1136
        • Antman E.M.
        • Anbe D.T.
        • Armstrong P.W.
        • Bates E.R.
        • Green L.A.
        • Hand M.
        • Hochman J.S.
        • Krumholz H.M.
        • Kushner F.G.
        • Lamas G.A.
        • Mullany C.J.
        • Ornato J.P.
        • Pearle D.L.
        • Sloan M.A.
        • Smith Jr., S.C.
        • Alpert J.S.
        • Anderson J.L.
        • Faxon D.P.
        • Fuster V.
        • Gibbons R.J.
        • Gregoratos G.
        • Halperin J.L.
        • Hiratzka L.F.
        • Hunt S.A.
        • Jacobs A.K.
        • American College of Cardiology
        • American Heart Association Task Force on Practice Guidelines
        • Canadian Cardiovascular Society
        ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction).
        Circulation. 2004; 110: e82-e292
        • Mendes R.G.
        • Simões R.P.
        • de Souza Melo Costa F.
        • Pantoni C.B.
        • Di Thommazo L.
        • Luzzi S.
        • Amaral-Neto O.
        • Catai A.M.
        • Arena R.
        • Borghi-Silva A.
        Left-ventricular function and autonomic cardiac adaptations after short-term inpatient cardiac rehabilitation: a prospective clinical trial.
        J Rehabil Med. 2011; 43: 720-727
        • Goble A.J.
        • Worcester M.U.C.
        Best practice guidelines for cardiac rehabilitation and secondary prevention. Heart Research Centre.
        Department of Human Services Victoria, Victoria1999: 238
        • Piotrowicz R.
        • Wolszakiewicz J.
        Cardiac rehabilitation following myocardial infarction.
        Cardiol J. 2008; 15: 481-487
        • Gonzáles A.I.
        • Sties S.W.
        • Wittkopf P.G.
        • Mara L.S.
        • Ulbrich A.Z.
        • Cardoso F.L.
        • Carvalho T.D.
        Validation of the International Index of Erectile Function (IIFE) for use in Brazil.
        Arq Bras Cardiol. 2013; 101: 176-182
        • Cappelleri J.C.
        • Rosen R.C.
        • Smith M.D.
        • Mishra A.
        • Osterloh I.H.
        Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function.
        Urology. 1999; 54: 346-351
        • ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories
        ATS statement: guidelines for the six-minute walk test.
        Am J Respir Crit Care Med. 2002; 166: 111-117
        • Iwama A.M.
        • Andrade G.N.
        • Shima P.
        • Tanni S.E.
        • Godoy I.
        • Dourado V.Z.
        The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects.
        Braz J Med Biol Res. 2009; 42: 1080-1085
        • Verrill D.E.
        • Barton C.
        • Beasley W.
        • Lippard M.
        • King C.N.
        Six-minute walk performance and quality of life comparisons in North Carolina cardiac rehabilitation programs.
        Heart Lung. 2003; 32: 41-51
        • Heran B.S.
        • Chen J.M.
        • Ebrahim S.
        • Moxham T.
        • Oldridge N.
        • Rees K.
        • Thompson D.R.
        • Taylor R.S.
        Exercise-based cardiac rehabilitation for coronary heart disease.
        Cochrane Database Syst Rev. 2011; : CD001800
        • Parker K.
        • Stone J.A.
        • Arena R.
        • Lundberg D.
        • Aggarwal S.
        • Goodhart D.
        • Traboulsi M.
        An early cardiac access clinic significantly improves cardiac rehabilitation participation and completion rates in low-risk ST-elevation myocardial infarction patients.
        Can J Cardiol. 2011; 27: 619-627
        • Worringham C.
        • Rojek A.
        • Stewart I.
        Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation.
        PLoS One. 2011; 6: e14669
        • Dalal H.M.
        • Zawada A.
        • Jolly K.
        • Moxham T.
        • Taylor R.S.
        Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis.
        BMJ. 2010; 340: c1133
        • NIH Consensus Development Panel on Impotence
        NIH Consensus Conference. Impotence.
        JAMA. 1993; 270: 83-90
        • Kloner R.A.
        • Mullin S.H.
        • Shook T.
        • Matthews R.
        • Mayeda G.
        • Burstein S.
        • Peled H.
        • Pollick C.
        • Choudhary R.
        • Rosen R.
        • Padma-Nathan H.
        Erectile dysfunction in the cardiac patient: how common and should we treat?.
        J Urol. 2003; 170: 46-50
        • Chiurlia E.
        • D'Amico R.
        • Ratti C.
        • Granata A.R.
        • Romagnoli R.
        • Modena M.G.
        Subclinical coronary artery atherosclerosis in patients with erectile dysfunction.
        J Am Coll Cardiol. 2005; 46: 1503-1506
        • Meldrum D.R.
        • Gambone J.C.
        • Morris M.A.
        • Meldrum D.A.
        • Esposito K.
        • Ignarro L.J.
        The link between erectile and cardiovascular health: the canary in the coal mine.
        Am J Cardiol. 2011; 108: 599-606
        • Gandaglia G.
        • Briganti A.
        • Jackson G.
        • Kloner R.A.
        • Montorsi F.
        • Montorsi P.
        • Vlachopoulos C.
        A systematic review of the association between erectile dysfunction and cardiovascular disease.
        Eur Urol. 2014; 65: 968-978
        • Montorsi P.
        • Ravagnani P.M.
        • Galli S.
        • Salonia A.
        • Briganti A.
        • Werba J.P.
        • Montorsi F.
        Association between erectile dysfunction and coronary artery disease: matching the right target with the right test in the right patient.
        Eur Urol. 2006; 50: 721-731
        • Jackson G.
        • Rosen R.C.
        • Kloner R.A.
        • Kostis J.B.
        The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine.
        J Sex Med. 2006; 3: 28-36
        • Bacon C.G.
        • Mittleman M.A.
        • Kawachi I.
        • Giovannucci E.
        • Glasser D.B.
        • Rimm E.B.
        Sexual function in men older than 50 years of age: results from the health professionals follow-up study.
        Ann Intern Med. 2003; 139: 161-168
        • Selvin E.
        • Burnett A.L.
        • Platz E.A.
        Prevalence and risk factors for erectile dysfunction in the US.
        Am J Med. 2007; 120: 151-157
        • Akkus E.
        • Kadioglu A.
        • Esen A.
        • Doran S.
        • Ergen A.
        • Anafarta K.
        • Hattat H.
        • Turkish Erectile Dysfunction Prevalence Study Group
        Prevalence and correlates of erectile dysfunction in Turkey: a population-based study.
        Eur Urol. 2002; 41: 298-304
        • Lamina S.
        • Agbanusi E.
        • Nwacha R.C.
        Effects of aerobic exercise in the management of erectile dysfunction: a meta analysis study on randomized controlled trials.
        Ethiop J Health Sci. 2011; 21: 195-201
        • Bellet R.N.
        • Adams L.
        • Morris N.R.
        The 6-minute walk test in outpatient cardiac rehabilitation: validity, reliability and responsiveness—a systematic review.
        Physiotherapy. 2012; 98: 277-286
        • Belardinelli R.
        • Lacalaprice F.
        • Faccenda E.
        • Purcaro A.
        • Perna G.
        Effects of short-term moderate exercise training on sexual function in male patients with chronic stable heart failure.
        Int J Cardiol. 2005; 101: 83-90
        • Hambrecht R.
        • Adams V.
        • Erbs S.
        • Linke A.
        • Kränkel N.
        • Shu Y.
        • Baither Y.
        • Gielen S.
        • Thiele H.
        • Gummert J.F.
        • Mohr F.W.
        • Schuler G.
        Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase.
        Circulation. 2003; 107: 3152-3158
        • Haram P.M.
        • Adams V.
        • Kemi O.J.
        • Brubakk A.O.
        • Hambrecht R.
        • Ellingsen O.
        • Wisloff U.
        Time-course of endothelial adaptation following acute and regular exercise.
        Eur J Cardiovasc Prev Rehabil. 2006; 13: 585-591