IJCS | Volume 32, Nº4, July/August 2019

DOI: 10.5935/2359-4802.20190054 418 REVIEW ARTICLE International Journal of Cardiovascular Sciences. 2019;32(4):418-427 Mailing Address: Ana Gonzáles Rua Maria Filomena da Silva, 207, apto 208. Postal Code: 88110-630, São José, SC – Brazil. E-mail: anainesgonzales@gmail.com Physical Exercise in the Management of Erectile Dysfunction in Patients with Heart Failure Ana Gonzáles, 1, 2 T ales de Carvalho, 2 L eonardo Andreato, 3 S abrina Sties, 2 Anelise Sonza 2 Faculdade Estácio de Sá de Santa Catarina, 1 São José, SC – Brazil Universidade do Estado de Santa Catarina, 2 Florianópolis, SC – Brazil Centro Universitário de Maringá, 3 Maringá, PR - Brazil Manuscript received on March 23, 2019, revised manuscript on April 27, 2019, accepted on May 04, 2019. Cardiovascular Diseases; Heart Failure; Exercise; Physical Finess, ErectileDysfunction; Aged; DrugTherapy. Keywords Abstract Erectile dysfunction (ED) is a highly prevalent problem that affects the quality of life, prognosis and survival of patients with heart failure (HF). In the management of ED, physical exercise is a therapeutic strategy that reduces disease-related symptoms and optimizes drug use. However, the repercussions of physical exercise on ED in individuals with HF still need to be elucidated. In this sense, the objective of this study was to evaluate the effects of physical exercise on erectile function (EF) in HF patients. This was a systematic review conducted according to PRISMA guidelines. Patients with HF, male and ejection fraction ≤ 45% were submitted to physical exercise of different modalities. The search for scientific articles was conducted in the electronic databases (PubMed, LILACS, Cochrane-Library, Science Direct) from the inception until October 2018, according to the MeSH dictionary descriptors, which were suitable for all databases. Results: Three studies were analyzed, includinng 99 male subjects, age ranging from 53 years (± 7.48) to 58 years (± 12). Seventy subjects were submitted to a physical exercise program and 29 were in the control group. In all studies, physical exercise showed positive results in the management of ED regardless of erectile dysfunction (ED) classification status and intensity of exercise used. It was concluded that physical exercise of different intensities was considered an effective therapeutic intervention to improve EF in individuals with HF and ED. Introduction Heart failure (HF) is the final common pathway of cardiovascular diseases and a complex syndrome involving multiple systems. 1,2 Recently, interest in the investigation of sexual dysfunction (SD) of these individuals has increased because it is considered a clinical problemof high severity and prevalence, 3-5 withmany pathophysiological aspects similar to HF syndrome. 6,7 Approximately 80% of patients with HF report SD and 30% report total abstinence from sexual activity. 3-5,8 In this context, the correlation between HF and erectile dysfunction (ED) deserves attention, especially considering that sexual function is an important component of quality of life (QoL). 5,9 Sexual problems are strongly related to worse QoL of HF patients, both men (52%) and women (38%). 10-13 Recently, it has been demonstrated that men with HF, younger than 66 years, monogamous, with ejection fraction below 35% are the individuals who report more difficulties in sexual life. 12,14 ED is defined and characterized as the inability to reach out and maintain the erection of the penis for enough time to allow Ana Inês Gonzáles, MD Centro Universitário Estácio de Santa Catarina anainesgonzales@gmail.com