Photoplethysmography-Derived Flow-Mediated Dilation as a Non-Invasive Marker of Endothelial Function in Erectile Dysfunction.

Background

Endothelial dysfunction plays a central role in the pathophysiology of erectile dysfunction (ED) and reflects systemic vascular impairment. Photoplethysmography-derived flow-mediated dilation (PPG-FMD) has emerged as a novel, non-invasive approach for assessing endothelial function. This study aimed to investigate the utility of PPG-FMD as a marker of systemic endothelial function in patients with ED without overt coronary artery disease.

Methods

In this observational cross-sectional comparative study, patients with vascular ED (n = 24), non-vascular ED (n = 18), and healthy controls (n = 30) were evaluated. Endothelial function was assessed using PPG-FMD. Key parameters, including dilation index, time to maximum dilation, area under the curve, and dilation index slope, were analyzed and compared across groups.

Results

PPG-FMD parameters indicated significantly impaired endothelial function in patients with vascular ED compared to both non-vascular ED patients and controls (p < 0.01). Dilation index and area under the curve were significantly reduced in the vascular ED group.

Conclusions

These preliminary findings support the presence of systemic endothelial dysfunction in vascular ED and suggest that PPG-FMD-derived parameters may serve as a non-invasive indicator of endothelial function. Further studies incorporating larger cohorts and validation against established endothelial assessment methods are required to determine its clinical applicability.