Testosterone and left ventricular diastolic function in men with heart failure

    Authors

    Keywords

    echocardiography, diastolic dysfunction, men, myocardial infarction, smoking, testosterone

    DOI

    https://doi.org/10.15836/ccar.2015.59

    Full Text

    ## Background Previous studies found no correlation between serum testosterone levels (TL) and left ventricular (LV) ejection fraction, but the role of testosterone in diastolic dysfunction (DD) is less understood. ## Methods Male patients hospitalized because of acute HF at the Department of Cardiology, University Hospital Center Split-Krizine between December 2011, and March 2014 were enrolled. The diagnosis was established according to clinical presentation and echocardiographic findings of either systolic (LV ejection fraction <45% assessed by the Simpson method) or DD. Color M-mode, pulsed-wave Doppler from the apical four-chamber view and tissue-Doppler imaging parameters of diastolic LV function were measured to assess the severity of DD according to four basic grades. ## Results Of the 121 patient, 31 (25.6%) had previous MI. They significantly more often used aspirin, loop diuretic, spironolactone or beta-blocker and have a significantly lower serum total TL and higher GFR (p<0.05 in all cases) compared to patients without a previous MI. There were no differences in average age, LV ejection fraction, cardiovascular risk factors or prehospital use of digoxin, angiotensin converting enzyme-inhibitor, angiotensin II receptor I blocker, calcium channel antagonist or statin. DD showed a significant inverse correlation with total TL (r=—0.222, p=0.001) in all patients, and the same trend was present separately in both men with (r=—0.334, p=0.07) and without (r=—0.198, p=0.06) previous MI. Multivariate analysis revealed that in all patients, both low total TL (ß=—0.244, p=0.006) and smoking (ß=—0.255, p=0.004) were significant predictors of DD severity. Among post-infarction patients only smoking (ß=0.604, p=0.0002) remained a strong independent predictor whereas in their counterpart group it was only low total TL (ß=—0.213, p=0.047). ## Conclusions The results of the present report suggest that lower TL could be an important factor in the development of DD in men with HF without previous MI. In HF patients who have had a MI, smoking seems to be the chief factor in the progression of DD.

    Cardiologia Croatica
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    Testosterone and left ventricular diastolic function in men with heart failure

    Abstract
    Issue3-4
    Published
    Pages59
    PDF via DOIhttps://doi.org/10.15836/ccar.2015.59
    echocardiography
    diastolic dysfunction
    men
    myocardial infarction
    smoking
    testosterone

    Authors

    Viktor Culic*ORCIDUniversity of Split School of Medicine, University Hospital Centre Split, Split, Croatia
    Zeljko BusicORCIDUniversity of Split School of Medicine, University Hospital Centre Split, Split, Croatia
    Marija BusicORCIDUniversity of Split School of Medicine, University Hospital Centre Split, Split, Croatia
    Marina Juric-PaicORCIDUniversity of Split School of Medicine, University Hospital Centre Split, Split, Croatia
    Adrijana LivajaORCIDUniversity of Split School of Medicine, University Hospital Centre Split, Split, Croatia

    *Correspondence email: viktor.culic@st.t-com.hr

    Full Text

    Background

    Previous studies found no correlation between serum testosterone levels (TL) and left ventricular (LV) ejection fraction, but the role of testosterone in diastolic dysfunction (DD) is less understood.

    Methods

    Male patients hospitalized because of acute HF at the Department of Cardiology, University Hospital Center Split-Krizine between December 2011, and March 2014 were enrolled. The diagnosis was established according to clinical presentation and echocardiographic findings of either systolic (LV ejection fraction <45% assessed by the Simpson method) or DD. Color M-mode, pulsed-wave Doppler from the apical four-chamber view and tissue-Doppler imaging parameters of diastolic LV function were measured to assess the severity of DD according to four basic grades.

    Results

    Of the 121 patient, 31 (25.6%) had previous MI. They significantly more often used aspirin, loop diuretic, spironolactone or beta-blocker and have a significantly lower serum total TL and higher GFR (p<0.05 in all cases) compared to patients without a previous MI. There were no differences in average age, LV ejection fraction, cardiovascular risk factors or prehospital use of digoxin, angiotensin converting enzyme-inhibitor, angiotensin II receptor I blocker, calcium channel antagonist or statin.

    DD showed a significant inverse correlation with total TL (r=—0.222, p=0.001) in all patients, and the same trend was present separately in both men with (r=—0.334, p=0.07) and without (r=—0.198, p=0.06) previous MI. Multivariate analysis revealed that in all patients, both low total TL (ß=—0.244, p=0.006) and smoking (ß=—0.255, p=0.004) were significant predictors of DD severity. Among post-infarction patients only smoking (ß=0.604, p=0.0002) remained a strong independent predictor whereas in their counterpart group it was only low total TL (ß=—0.213, p=0.047).

    Conclusions

    The results of the present report suggest that lower TL could be an important factor in the development of DD in men with HF without previous MI. In HF patients who have had a MI, smoking seems to be the chief factor in the progression of DD.