Background: In addition to a beneficial effect on exercise tolerance and an associated reduction of global cardiovascular risk, modificationof physical activity has a positive effect on the quality of life, reducing, among other things, the severity of erectile dysfunction (ED).

Aim: The specific nature of sexual activity, which combines the need to maintain appropriate exercise tolerance and good erection quality, prompted us to evaluate the association between exercise tolerance and severity of ED in an intervention group of subjectswith ischaemic heart disease (IHD) and ED in the context of cardiac rehabilitation (CR).

Methods: A total of 138 men treated invasively for IHD (including 99 treated with percutaneous coronary intervention and 39 treatedwith coronary artery bypass grafting) who scored 21 or less in the initial IIEF-5 test were investigated. Subjects were randomised intotwo groups. The study group included 103 subjects (mean age 62.07 ± 8.59 years) who were subjected to a CR cycle. The controlgroup included 35 subjects (mean age 61.43 ± 8.81 years) who were not subjected to any CR. All subjects filled out an initialand final IIEF-5 questionnaire and were evaluated twice with a treadmill exercise test. The CR cycle was carried out for a periodof 6 months and included interval endurance training on a cycle ergometer (three times a week) and general fitness exercises andresistance training (twice a week).

Results: The CR cycle in the study group resulted in a statistically significant increase in exercise tolerance (7.15 ± 1.69 vs. 9.16 ± 1.84 METs,p < 0.05) and an increase in erection quality (12.51 ± 5.98 vs. 14.39 ± 6.82, p < 0.05) which was not observed in the controlgroup. A significant effect of age on a progressive decrease in exercise tolerance and erection quality was found in the study group. Exercise tolerance and erection quality were also negatively affected by hypertension and smoking. A significant correlation between exercise tolerance and erection quality prior to the rehabilitation cycle indicates better erection quality in patients with better effort tolerance. The improvement in exercise tolerance did not correlate significantly with initial exercise tolerance or age of the subjects. Incontrast, a significantly higher increase in erection quality was observed in younger subjects with the lowest baseline severity of ED.The relative increase in exercise tolerance in the group subjected to CR was significantly higher than the relative increase in erection quality but these two effects were not significantly correlated with each other.

Conclusions: 1. In subjects with IHD and ED, erection quality is significantly correlated with exercise tolerance. 2. Exercise traininghad a positive effect on both exercise tolerance and erection quality but the size of these two effects was different and they ran independently of each other.