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

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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.

Section snippets

Methods

This study was performed at the São Paulo Hospital, Federal University of São Paulo, from February 2011 to December 2013. The institutional ethics committee approved this randomized controlled study. Before study inclusion, all patients were informed about the study, and a signed consent form was obtained from each subject.

The subjects were prospectively selected from patients with AMIs within the first 12 hours of intensive care unit admission who underwent successful percutaneous coronary

Results

During the study period, 574 patients were assessed for eligibility, and from that sample, 100 were allocated to 2 groups, with 86 ultimately accomplishing the protocol (Figure 1). The groups were homogenous, and no statistical difference was found with respect to key baseline characteristics, as listed in Table 1.

In the overall cohort, 72 subjects (84%) reported previous ED on the IIEF questionnaire at hospital discharge. At 30 days after discharge, ED prevalence had increased by 9% in the

Discussion

This is the first randomized controlled study to evaluate the impact of an unsupervised, home-based, progressive walking program on sexual function and functional capacity in men after recent AMIs at low cardiovascular risk. This study demonstrates that the intervention resulted in significantly better improvements in submaximal functional capacity and sexual function compared with a control group. Our findings are therefore novel and of potential clinical importance.

Although exercise-based

Disclosures

The authors have no conflicts of interest to disclose.

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