Effect of angiotensin receptor-neprilysin inhibitor treatment on erectile dysfunction in heart failure with a reduced ejection fraction

Objective: Erectile dysfunction (ED) is a common condition in patients with heart failure (HF), which impairs quality of life. Our study aimed to compare those patients, who received traditional treatment with a diagnosis of HF and those who received angiotensin receptor-neprilysin inhibitor (ARNI) treatment in addition to the current treatment, in terms of ED at the end of 6 months. Patients and Methods: The study was planned as a single-center, prospective study. The study included 200 patients with heart failure. The patients’ demographic, clinical, and echocardiographic characteristics were recorded, and an international ED scoring questionnaire was applied. The participants in the study were divided into two groups: those who received ARNI treatment and those who did not. After 6 months, the ED questionnaire was applied to the patients again and the groups were compared. Results: The median age of the patients was 53 (years). The median ejection fraction (EF) value was calculated to be 30% and no significant difference was found between the groups (p: 0.122). It was found that N-terminal pro-brain natriuretic peptide (NT-pro- BNP) levels measured at the end of the 6th month were significantly lower in patients who had received ARNI treatment than in those who had not (respectively, 245 pg/ml, 200 pg/ml; p: 0.003). In the analysis performed to detect the presence of ED, it was discovered that the ED score change was significantly higher in the group that had received 6 months of ARNI treatment (p: 0.031) compared to that in the group that had not (p: 0.031). When the ED sub-parameters were compared in terms of the 6-month change rate, it was found that the ARNI group had a significant increase in terms of ED and sexual satisfaction scores, but no significant difference was found in the other parameters (p: 0.001, p: 0.029). Conclusion: Erectile dysfunction is more common in patients with heart failure compared to the rest of society and impairs quality of life. In our study, it was determined that ED complaints decreased significantly in HF patients, who had received ARNI treatment for 6 months than in patients who had not.