Low T Tied to Heart Failure Outcomes
Low serum testosterone is associated with higher mortality risk in men with heart failure (HF), according to a recent study.
The relationship between testosterone levels and cardiovascular health has been described in previous research, and it has been suggested that anabolic hormone deficiency is linked to poor outcomes in men with HF.
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In order to clarify the association between testosterone and HF, researchers conducted a prospective observational study involving 702 men with decompensated HF discharged from the hospital between 2009 and 2015 in Japan. Of the 702 patients, 618 were enrolled in the study.
The participants were divided into quartiles based on their total testosterone (TT) levels: 1st (632 ng/dl ≤ TT, n = 154), 2nd (463 ≤ TT ≤ 631, n = 155), 3rd (462 ≤ TT ≤ 301, n = 156), and 4th quartiles (TT ≤ 300, n = 153).
After Kaplan-Meier analysis, the researchers found that all-cause mortality progressively increased from the 1st to 4th groups. In multivariable Cox proportional hazard analysis, TT was also found to be an independent predictor of all-cause mortality.
Levels of B-type natriuretic peptide and cardiac troponin I, as well as parameters of echocardiography and cardiopulmonary exercise testing were also compared between the 4 groups. Overall, left ventricular ejection fraction and B-type natriuretic peptide did not differ among the groups, while the 4th group had higher levels of troponin I and lower peak VO2 than did the 1st, 2nd, and 3rd groups.
“In conclusion, decreased testosterone is associated with adverse prognosis, accompanied by hypoalbuminemia, anemia, inflammation, myocardial damage, increased arterial stiffness, and impaired exercise capacity, in men with HF.”
—Michael Potts
Reference:
Yoshihisa A, Suzuki S, Sato Y, et al. relation of testosterone levels to mortality in men with heart failure [published online March 1, 2018]. Am J Cardiol. doi: https://doi.org/10.1016/j.amjcard.2018.01.052.