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. 2016 Apr;16(4):256-63.
doi: 10.5152/anatoljcardiol.2015.6122. Epub 2015 Jul 14.

Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease

Dariusz Kałka  1 , Zygmunt Domagała, Leslaw Rusiecki, Łukasz Karpiński, Jana Gebala, Piotr Kolęda, Malgorzata Rusiecka, Bohdan Gworys, Witold Pilecki
Affiliations

Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease

Dariusz Kałka et al. Anatol J Cardiol. 2016 Apr.

Abstract

Objective: Heart rate recovery (HRR) is a recognised marker used in clinical practice for assessing the risk of sudden cardiac death. Physical exercise leads to an improvement in HRR and has a proven beneficial effect on erection quality (EQ) related to the activity of the autonomic nervous system in men with ischaemic heart disease (IHD). This paper evaluates the relationship between HRR and EQ in patients with IHD and erectile dysfunction (ED) who underwent cardiac rehabilitation.

Methods: The main analysis was based on the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman correlation coefficient, Pearson's chi-square test, chi-square test, with the Yates correction and (if possible) parametric tests were used. This prospective, non-randomised intervention study included 124 men with IHD and ED [International Index of Erectile Function (IIEF-5) scores of ≤21]. Of these, 89 patients underwent a 6-month cardiac rehabilitation phase III programme, whereas 35 did not. The results of the participants' total IIEF-5 scores and their HRR, demographic and clinical data were analysed.

Results: The results of the 89 rehabilitated patients (mean age: 60.44±9.29 years) and 35 controls (mean age: 61.43±8.81 years) were analysed. In the rehabilitated patients, the mean baseline IIEF-5 score was 13.15±5.76 (95% CI: 11.93-14.36) and HRR was 16.49±7.68/min (95% CI: 14.88-18.11). After cardiac rehabilitation, the parameters of ED and HRR improved significantly and were significantly higher than those of the controls; the mean IIEF-5 score of the rehabilitated group increased to 15.36±6.51 (95% CI: 13.99-16.73), while HRR increased to 21.40±7.25/min (95% CI: 19.88-22.93). A significant correlation was found between ∆HRR and ∆EQ (r=0.409791) as a result of the 6-month cardiac training programme.

Conclusion: Cardiac rehabilitation assessed by HRR has a sizable effect on autonomic balance in patients with IHD and ED, which plays a significant role in the mechanism of erection improvement.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Methodology of cardiac rehabilitation. (1) Cycle ergometer training: the load on cycle ergometers was increased at 4-min intervals until halfway through the training, when the patients achieved their peak; the load was then declined to the initial values, interrupted by 2-min recovery periods, with a maintained load of 0–5 W. Training began with a 2-min-long warm-up and finished with a 3-min-long rest phase (no load). (2) General and resistance training: the training consisted of relaxation, stretching, balance and skill exercises performed in groups. Exercises at the gymnasium were supplemented by elements of resistance training that included 8–10 resistance movements for different groups of muscles. All exercises were performed in series of 12–15 repetitions.
Figure 2
Figure 2
Heart rate during the exercise stress test. Point HR0 indicates the beginning of a rest phase, which started when the maximum heart rate was reached during the treadmill exercise test. Point HR60 indicates the moment of measurement of heart rate recovery (HRR), which was 60 s after the beginning of the rest phase
Figure 3
Figure 3
Erectile dysfunction intensity (EQ) and heart rate recovery (HRR) before (1) and after (2) cardiac rehabilitation in the study (E) and control (C) groups (mean, mean±SD and 95% confidence interval)
Figure 4
Figure 4
Correlation between ΔEQ and ΔHRR (Additionally regression line is visible)
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