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

Abstract

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.