Document Detail

Reduction in circulating testosterone relates to exercise capacity in men with chronic heart failure.
MedLine Citation:
PMID:  19477405     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We investigated whether anabolic deficiency was linked to exercise intolerance in men with chronic heart failure (CHF). Anabolic hormones (testosterone, dehydroepiandrosterone sulfate, insulin-like growth factor 1 [IGF1]) contribute to exercise capacity in healthy men. This issue remains unclear in CHF. METHODS AND RESULTS: We studied 205 men with CHF (age 60 +/- 11 years, New York Heart Association [NYHA] Class I/II/III/IV: 37/95/65/8; LVEF [left ventricular ejection fraction]: 31 +/- 8%). Exercise capacity was expressed as peak oxygen consumption (peak VO(2)), peak O(2) pulse, and ventilatory response to exercise (VE-VCO(2) slope). In multivariable models, reduced peak VO(2) (and reduced peak O(2) pulse) was associated with diminished serum total testosterone (TT) (P < .01) and free testosterone (eFT; estimated from TT and sex hormone globulin levels) (P < .01), which was independent of NYHA Class, plasma N-terminal pro-brain natriuretic peptide, and age. These associations remained significant even after adjustment for an amount of leg lean tissue. In multivariable models, high VE-VCO(2) slope was related to reduced serum IGF1 (P < .05), advanced NYHA Class (P < .05), increased plasma NT-proBNP (P < .0001), and borderline low LVEF (P = .07). In 44 men, reassessed after 2.3 +/- 0.4 years, a reduction in peak VO(2) (and peak O(2) pulse) was accompanied by a decrease in TT (P < .01) and eFT (P <or= .01). Increase in VE-VCO(2) slope was related only to an increase in plasma NT-proBNP (P < .05). CONCLUSIONS: In men with CHF, low circulating testosterone independently relates to exercise intolerance. The greater the reduction of serum TT in the course of disease, the more severe the progression of exercise intolerance. Whether testosterone supplementation would improve exercise capacity in hypogonadal men with CHF requires further studies.
Ewa A Jankowska; Gerasimos Filippatos; Beata Ponikowska; Ludmila Borodulin-Nadzieja; Stefan D Anker; Waldemar Banasiak; Philip A Poole-Wilson; Piotr Ponikowski
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-02-10
Journal Detail:
Title:  Journal of cardiac failure     Volume:  15     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-29     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  442-50     Citation Subset:  IM    
Cardiology Department, Military Hospital, Wroclaw, Poland.
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MeSH Terms
Exercise Test
Exercise Tolerance / physiology*
Follow-Up Studies
Heart Failure / blood*,  physiopathology
Middle Aged
Retrospective Studies
Severity of Illness Index
Testosterone / blood*
Grant Support
//British Heart Foundation
Reg. No./Substance:

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