Hormonal profile in patients with congestive heart failure

Kontoleon, P; Anastasiou-Nana, Maria; Papapetrou, Peter D.; Alexopoulos, Georgios; Ktenas, Vasiliki; Rapti, Ageliki; Tsagalou, Eleftheria P.; Nanas, John N.

doi:10.1016/s0167-5273(02)00212-7

Cited by 131 publications

(83 citation statements)

References 39 publications

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“…In the clinical setting, male patients with chronic heart failure exhibit declines in serum androgen levels (Anker et al 1997, Kiilavuori et al 1999, Moriyama et al 2000, Kontoleon et al 2003, and deficiencies in circulating androgens, including testosterone, in men with chronic heart failure have been shown to be independent predictors of poor outcome (Jankowska et al 2010). On the other hand, administration of testosterone with moderate heart failure has been shown to reduce left ventricular mass index, indicating the amelioration of cardiac hypertrophy without improving cardiac function.…”

Section: Androgen Effects On Cardiac Remodelingmentioning

confidence: 99%

Effects of androgens on cardiovascular remodeling

Ikeda

Aihara

Yoshida³

et al. 2012

Journal of Endocrinology

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Androgens, the male sex hormones, exert various biological effects on many target organs through the transcriptional effects of the nuclear androgen receptor (AR). ARs are expressed not only in classical target organs, such as the brain, genital organs, bone, and skeletal muscles, but also in the cardiovascular system. Because the female sex hormones estrogens are wellknown to protect against cardiovascular disease, sex has been considered to have a significant clinical impact on cardiovascular mortality. However, the influence of androgens on the cardiovascular system has not been fully elucidated. To clarify this issue, we analyzed the effects of administration of angiotensin II and doxorubicin, an anticancer agent, in a loading model in male wild-type and AR-deficient mice. In this review, we focus on the actions of androgens as potential targets for the prevention of cardiovascular diseases in males.

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Section: Androgen Effects On Cardiac Remodelingmentioning

confidence: 99%

Effects of androgens on cardiovascular remodeling

Ikeda

Aihara

Yoshida³

et al. 2012

Journal of Endocrinology

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“…Decrease of these hormones is related to age and contributes to gradual worsening of tolerance to exertion in older men (8,9) . Testosterone deficiency and consequent worsening of the anabolism/catabolism ratio is a pathophysiological characteristic of patients, even young ones, with advanced HF (10)(11)(12)(13)(14) , contributing to the decrease of muscle mass, weakness, fatigue, dyspnea and cachexia. However, the TRT effects in patients with HF, even with severe androgenic deficiency and cachexia clinical episode, have been little investigated until the present moment.…”

Section: Testosterone and Exercise Synergism In Heart Failurementioning

confidence: 99%

“…Hypotestosteronemia has been described in patients with HF (10)(11)(12) . According to the muscular hypothesis, which is based on the neurohormone alteration and altered balance between catabolism/ anabolism in favor to catabolism, the disease may progress from a controlled catabolic state to heart cachexia, which is defined as unintentional loss of lean mass above 6kg in six months (16)(17)(18)(19) .…”

Section: Heart Failure Catabolism and Testosteronementioning

confidence: 99%

“…The low serum testosterone level, frequently found in studies with patients with HF, is considered a marker of worse prognosis, regardless of the predictors of conventional risks and of the cause for the disease (20)(21)(22) . The prevalence of hypotestosteronemia (hypogonadism) ranges between 25 and 30%, being the high mortality and morbidity rates associated with the low levels of androgens, even in the absence of cachexia (12,23,24) .…”

Section: Heart Failure Catabolism and Testosteronementioning

confidence: 99%

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Reposição hormonal e exercício físico no tratamento da insuficiência cardíaca: revisão sistemática

Carvalho

Mara

Ulbrich

2011

Rev Bras Med Esporte

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Background: Despite the full use of pharmacological and non-pharmacological therapy, morbidity and mortality incidence as a result from heart failure (HF) are still significantly persistent. In the therapeutic context, the inhibition of inadequate neuro-hormonal and metabolic adaptations, as well the information on the anabolic deficiency that develops in HF becomes relevant. However, just recently some studies about the benefits of the testosterone replacement or supplementation therapy (TRT) have emerged. Objective: to review studies that address the TRT in heart failure (HF), particularly those developed in the ideal setting for clinical treatment, including physical exercise program. Methods: the Scielo and Pubmed databases, Cochrane of Systematic Review and Clinical Control Trials from Cochrane Collaboration databases were analyzed. Results: The few studies about TRT in patients with HF showed improvement in hemodynamic function, insulin resistance, functional capacity and neuro-hormonal and neuromuscular responses, highlighted the controversy regarding the influence on the inflammatory profile, and found no changes in function and structure in the central cardiovascular system. However, studies about TRT associated with exercise programs have not been found. Conclusion: the present state of knowledge, although based on a few studies, allows considering TRT in the treatment of patients with HF. The ideal choice of TRT, regarding for example, treatment duration and inclusion and exclusion criteria is not well-defined yet. There is a wide gap in the literature, calling attention to the lack of studies about TRT concomitant with full medical treatment which includes a physical exercise program.

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“…4 Abnormal serum levels of GH, which acts on cardiac myocytes primarily through IGF-1, are associated with abnormalities of myocardial growth and function that can be ameliorated with restoration of GH/IGF-1 homeostasis, as demonstrated by experience with patients with deficiency or hypersecretion of GH. 5,6 Studies in animal models of heart failure have demonstrated salutary effects of exogenous GH, including increased left ventricular (LV) mass, improved LV function, and preservation of myocyte Ca 2ϩ homeostasis and ␤-adrenoceptor responsiveness.…”

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confidence: 99%

Recombinant Human Growth Hormone Treatment for Dilated Cardiomyopathy in Children

et al. 2004

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ABSTRACT. Objective. Dilated cardiomyopathy (DCM) is one of the most common causes of heart failure among children and is often progressive despite maximal medical therapy. Heart failure is characterized by a number of neurohormonal abnormalities, including derangements in the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) signaling axis. Decreased serum levels of GH, which acts on cardiac myocytes primarily through IGF-1, are associated with impaired myocardial growth and function, which can be improved with restoration of GH/IGF-1 homeostasis. In animal models and among human adults with heart failure attributable to DCM, treatment with GH results in acquisition of left ventricular (LV) mass and improved LV function, through a combination of mechanisms. We undertook this study to determine the effects of recombinant human GH on LV function and mass among children with stable LV dysfunction attributable to DCM.Methods. We performed a prospective, single-center, randomized, partially blinded, crossover trial among children 1 to 19 years of age with DCM and cardiac dysfunction of >6-month duration. After enrollment, patients were randomly assigned to receive treatment for 6 months with either conventional therapy (determined by the patient's primary cardiologist) plus recombinant human GH (0.025-0.04 mg/kg per day), administered as daily subcutaneous injections, or conventional therapy alone. Patients were then crossed over to the other treatment strategy for 6 months. The primary outcome measure was change in LV shortening fraction (SF). Other echocardiographic indices of LV function, somatic growth, and somatotropic/thyroid hormone levels were also monitored.Results. Only 8 of an intended 15 patients were enrolled, because of a combination of factors. Two patients withdrew during the study as a result of declining LV function requiring transplantation. LV SF did not change significantly during GH treatment, although both LV SF and LV SF z score were higher 6 months after cessation of GH treatment than at baseline. LV ejection fraction increased during GH therapy to a degree that approached significance. Height and weight percentiles for age increased significantly during GH therapy and remained higher 6 months after treatment. Annualized height velocity during GH treatment (13.7 ؎ 3.3 cm/year, >97th percentile for all patients) was significantly higher than that after GH discontinuation (3.2 ؎ 3.5 cm/year). Serum levels of IGF-1 and IGF-binding protein-3 were significantly higher after 6 months of GH treatment and 6 months after discontinuation of GH treatment than at baseline. There were no adverse events related to GH treatment.Discussion. In this prospective, single-center, randomized, partially blinded, crossover trial, recombinant human GH was administered to 8 pediatric patients with stable chronic heart failure secondary to DCM. Because of unanticipated difficulty enrolling eligible patients, the study was underpowered to detect changes in our primary outcome measure of the magnitude we project...

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Hormonal profile in patients with congestive heart failure

Cited by 131 publications

References 39 publications

Effects of androgens on cardiovascular remodeling

Effects of androgens on cardiovascular remodeling

Reposição hormonal e exercício físico no tratamento da insuficiência cardíaca: revisão sistemática

Recombinant Human Growth Hormone Treatment for Dilated Cardiomyopathy in Children

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