Document Detail


Effect of long-acting testosterone treatment on functional exercise capacity, skeletal muscle performance, insulin resistance, and baroreflex sensitivity in elderly patients with chronic heart failure a double-blind, placebo-controlled, randomized study.
MedLine Citation:
PMID:  19712802     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study investigated the effect of a 12-week long-acting testosterone administration on maximal exercise capacity, ventilatory efficiency, muscle strength, insulin resistance, and baroreflex sensitivity (BRS) in elderly patients with chronic heart failure (CHF). BACKGROUND: CHF is characterized by a metabolic shift favoring catabolism and impairment in skeletal muscle bulk and function that could be involved in the pathophysiology of heart failure. METHODS: Seventy elderly patients with stable CHF-median age 70 years, ejection fraction 31.8 +/- 7%-were randomly assigned to receive testosterone (n = 35, intramuscular injection every 6 weeks) or placebo (n = 35), both on top of optimal medical therapy. At baseline and at the end of the study, all patients underwent echocardiogram, cardiopulmonary exercise test, 6-min walk test (6MWT), quadriceps maximal voluntary contraction (MVC), and isokinetic strength (peak torque) and BRS assessment (sequences technique). RESULTS: Baseline peak oxygen consumption (VO(2)) and quadriceps isometric strength showed a direct relation with serum testosterone concentration. Peak VO(2) significantly improved in testosterone but was unchanged in placebo. Insulin sensitivity was significantly improved in testosterone. The MVC and peak torque significantly increased in testosterone but not in placebo. The BRS significantly improved in testosterone but not in placebo. Increase in testosterone levels was significantly related to improvement in peak VO(2) and MVC. There were no significant changes in left ventricular function either in testosterone or placebo. CONCLUSIONS: These results suggest that long-acting testosterone therapy improves exercise capacity, muscle strength, glucose metabolism, and BRS in men with moderately severe CHF. Testosterone benefits seem to be mediated by metabolic and peripheral effects.
Authors:
Giuseppe Caminiti; Maurizio Volterrani; Ferdinando Iellamo; Giuseppe Marazzi; Rosalba Massaro; Marco Miceli; Caterina Mammi; Massimo Piepoli; Massimo Fini; Giuseppe M C Rosano
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  54     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-28     Completed Date:  2009-09-23     Revised Date:  2010-05-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  919-27     Citation Subset:  AIM; IM    
Affiliation:
Centre for Clinical and Basic Research, Cardiovascular Research Unit, Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Baroreflex / drug effects*
Blood Glucose / analysis
Chronic Disease
Double-Blind Method
Echocardiography
Exercise Test
Exercise Tolerance / drug effects*
Heart Failure / blood,  drug therapy,  physiopathology*,  ultrasonography
Humans
Injections, Intramuscular
Insulin Resistance*
Leg
Male
Muscle Strength / drug effects
Muscle, Skeletal / drug effects*,  physiopathology
Oxygen Consumption / drug effects
Testosterone / administration & dosage,  analogs & derivatives*,  blood
Testosterone Congeners / administration & dosage*
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Testosterone Congeners; 58-22-0/Testosterone; 5949-44-0/testosterone undecanoate
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 May 18;55(20):2290; author reply 2290-1   [PMID:  20466211 ]
J Am Coll Cardiol. 2009 Sep 1;54(10):928-9   [PMID:  19712803 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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