Effect of long-acting testosterone treatment on functional exercise capacity, skeletal muscle performance, insulin resistance, and baroreflex sensitivity in elderly patients with chronic heart failure a double-blind, placebo-controlled, randomized study - PubMed (original) (raw)
Randomized Controlled Trial
. 2009 Sep 1;54(10):919-27.
doi: 10.1016/j.jacc.2009.04.078.
Affiliations
- PMID: 19712802
- DOI: 10.1016/j.jacc.2009.04.078
Free article
Randomized Controlled Trial
Effect of long-acting testosterone treatment on functional exercise capacity, skeletal muscle performance, insulin resistance, and baroreflex sensitivity in elderly patients with chronic heart failure a double-blind, placebo-controlled, randomized study
Giuseppe Caminiti et al. J Am Coll Cardiol. 2009.
Free article
Abstract
Objectives: This study investigated the effect of a 12-week long-acting testosterone administration on maximal exercise capacity, ventilatory efficiency, muscle strength, insulin resistance, and baroreflex sensitivity (BRS) in elderly patients with chronic heart failure (CHF).
Background: CHF is characterized by a metabolic shift favoring catabolism and impairment in skeletal muscle bulk and function that could be involved in the pathophysiology of heart failure.
Methods: Seventy elderly patients with stable CHF-median age 70 years, ejection fraction 31.8 +/- 7%-were randomly assigned to receive testosterone (n = 35, intramuscular injection every 6 weeks) or placebo (n = 35), both on top of optimal medical therapy. At baseline and at the end of the study, all patients underwent echocardiogram, cardiopulmonary exercise test, 6-min walk test (6MWT), quadriceps maximal voluntary contraction (MVC), and isokinetic strength (peak torque) and BRS assessment (sequences technique).
Results: Baseline peak oxygen consumption (VO(2)) and quadriceps isometric strength showed a direct relation with serum testosterone concentration. Peak VO(2) significantly improved in testosterone but was unchanged in placebo. Insulin sensitivity was significantly improved in testosterone. The MVC and peak torque significantly increased in testosterone but not in placebo. The BRS significantly improved in testosterone but not in placebo. Increase in testosterone levels was significantly related to improvement in peak VO(2) and MVC. There were no significant changes in left ventricular function either in testosterone or placebo.
Conclusions: These results suggest that long-acting testosterone therapy improves exercise capacity, muscle strength, glucose metabolism, and BRS in men with moderately severe CHF. Testosterone benefits seem to be mediated by metabolic and peripheral effects.
Comment in
- Testosterone: a novel therapeutic approach in chronic heart failure?
Aukrust P, Ueland T, Gullestad L, Yndestad A. Aukrust P, et al. J Am Coll Cardiol. 2009 Sep 1;54(10):928-9. doi: 10.1016/j.jacc.2009.05.039. J Am Coll Cardiol. 2009. PMID: 19712803 No abstract available. - Inadequate masking of testosterone.
Handelsman DJ. Handelsman DJ. J Am Coll Cardiol. 2010 May 18;55(20):2290; author reply 2290-1. doi: 10.1016/j.jacc.2009.09.073. J Am Coll Cardiol. 2010. PMID: 20466211 No abstract available.
Similar articles
- PDE 5 inhibition with udenafil improves left ventricular systolic/diastolic functions and exercise capacity in patients with chronic heart failure with reduced ejection fraction; A 12-week, randomized, double-blind, placebo-controlled trial.
Kim KH, Kim HK, Hwang IC, Cho HJ, Je N, Kwon OM, Choi SJ, Lee SP, Kim YJ, Sohn DW. Kim KH, et al. Am Heart J. 2015 Jun;169(6):813-822.e3. doi: 10.1016/j.ahj.2015.03.018. Epub 2015 Apr 1. Am Heart J. 2015. PMID: 26027619 Clinical Trial. - Testosterone Replacement Therapy in Deficient Patients With Chronic Heart Failure: A Randomized Double-Blind Controlled Pilot Study.
Navarro-Peñalver M, Perez-Martinez MT, Gómez-Bueno M, García-Pavía P, Lupón-Rosés J, Roig-Minguell E, Comin-Colet J, Bayes-Genis A, Noguera JA, Pascual-Figal DA. Navarro-Peñalver M, et al. J Cardiovasc Pharmacol Ther. 2018 Nov;23(6):543-550. doi: 10.1177/1074248418784020. Epub 2018 Jun 21. J Cardiovasc Pharmacol Ther. 2018. PMID: 29929385 Clinical Trial. - Testosterone therapy during exercise rehabilitation in male patients with chronic heart failure who have low testosterone status: a double-blind randomized controlled feasibility study.
Stout M, Tew GA, Doll H, Zwierska I, Woodroofe N, Channer KS, Saxton JM. Stout M, et al. Am Heart J. 2012 Dec;164(6):893-901. doi: 10.1016/j.ahj.2012.09.016. Epub 2012 Oct 30. Am Heart J. 2012. PMID: 23194490 Clinical Trial. - The effect of metformin on insulin resistance and exercise parameters in patients with heart failure.
Wong AK, Symon R, AlZadjali MA, Ang DS, Ogston S, Choy A, Petrie JR, Struthers AD, Lang CC. Wong AK, et al. Eur J Heart Fail. 2012 Nov;14(11):1303-10. doi: 10.1093/eurjhf/hfs106. Epub 2012 Jun 27. Eur J Heart Fail. 2012. PMID: 22740509 Review. - Randomized controlled trials - mechanistic studies of testosterone and the cardiovascular system.
Jones TH, Kelly DM. Jones TH, et al. Asian J Androl. 2018 Mar-Apr;20(2):120-130. doi: 10.4103/aja.aja_6_18. Asian J Androl. 2018. PMID: 29442075 Free PMC article. Review.
Cited by
- Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial.
von Haehling S, Doehner W, Evertz R, Garfias-Veitl T, Derad C, Diek M, Karakas M, Birkemeyer R, Fillippatos G, Lainscak M, Butler J, Ponikowski P, Böhm M, Friede T, Anker SD. von Haehling S, et al. Eur Heart J. 2024 Oct 5;45(37):3789-3800. doi: 10.1093/eurheartj/ehae479. Eur Heart J. 2024. PMID: 39185895 Free PMC article. Clinical Trial. - The Dual Burden of Frailty and Heart Failure.
Vitale C, Spoletini I, Rosano GMC. Vitale C, et al. Int J Heart Fail. 2024 Apr 15;6(3):107-116. doi: 10.36628/ijhf.2023.0057. eCollection 2024 Jul. Int J Heart Fail. 2024. PMID: 39081645 Free PMC article. Review. - Association of testosterone with myocardial infarction and severity of coronary artery disease among male patients.
Tang L, Chen M, Li J, Xu X, Pu X. Tang L, et al. Int J Cardiol Cardiovasc Risk Prev. 2024 May 7;21:200281. doi: 10.1016/j.ijcrp.2024.200281. eCollection 2024 Jun. Int J Cardiol Cardiovasc Risk Prev. 2024. PMID: 38779505 Free PMC article. - Comparing the Impacts of Testosterone and Exercise on Lean Body Mass, Strength and Aerobic Fitness in Aging Men.
Green DJ, Chasland LC, Yeap BB, Naylor LH. Green DJ, et al. Sports Med Open. 2024 Apr 2;10(1):30. doi: 10.1186/s40798-024-00703-x. Sports Med Open. 2024. PMID: 38563849 Free PMC article. Review. - Molecular mechanisms underlying sarcopenia in heart failure.
Rutledge CA. Rutledge CA. J Cardiovasc Aging. 2024 Jan;4(1):7. doi: 10.20517/jca.2023.40. Epub 2023 Dec 31. J Cardiovasc Aging. 2024. PMID: 38455513 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical