Author`s Reply.

To the Editor,

We read the letter about our article entitled “Deterioration of heart rate recovery index in patients with erectile dysfunction” published in the April issue of Anatolian Journal of Cardiology 2016; 16: 264-9 (1). The authors evaluated only the HRR1 parameter and stated “It would be too generous to claim that patients with erectile dysfunction (ED) have impairment in autonomic nervous system (ANS).”

First, we analyzed all heart rate recovery (HRR) indices (HRR1, HRR2, HRR3, and HRR5) and not only HRR1 to determine the ANS dysfunction in ED patients. In our study, we found significant differences in all parameters between control and patient groups. Although the author’s comment about HRR1 is acceptable, other HRR indices, especially HRR2, had an abnormal range in ED patients, whereas it had a normal range in the healthy group. Furthermore, we found that HRR1 and HRR3 were independent risk factors for ED in linear multivariate regression analysis.

When all these results are evaluated together, the significant differences in HRR indices between the two groups are thought to be associated with both low exercise capacity and ANS dysfunction in ED patients.