Acute haemodynamic effects of oestrogen administration in male patients with chronic heart failure (original) (raw)
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Effects of Hormonal Therapy in Patients with Heart Failure
Chronic heart failure is a multi-etiological disorder with high prevalence and poor prognosis. Several hormonal deficits have been observed in a consistent proportion of patients with this disease. Among them, testosterone deficiency and growth hormone/ insulin-like growth factor-1 axes impairment are highly prevalent and have been associated with a poor prognosis. Several experimental papers have highlighted the positive influence of growth hormone and testosterone in the regulation of heart development and performance. Moreover, many clinical studies have been started to investigate the effect of the administration of these two hormones in heart failure patients; a greater benefit has been evidenced in patients with hormonal deficiencies, by restoring physiological levels with hormonal therapy. These findings are promising, and, although not unanimously, indicate that both testosterone and growth hormone therapy should be considered as adjunctive therapy in advanced heart failure ...
Testosterone Therapy in Women With Chronic Heart Failure
Journal of the American College of Cardiology, 2010
The primary objective of this study was to assess the effect of a 6-month testosterone supplementation therapy on functional capacity and insulin resistance in female patients with chronic heart failure (CHF).
World journal of cardiology, 2015
Heart failure (HF) is a syndrome recognized as a health problem worldwide. Despite advances in treatment, patients with HF still have increased morbidity and mortality. Testosterone is one of the most researched hormones in the course of HF. Growing interest regarding the effect of testosterone, on a variety of body systems, has increased the knowledge about its mechanisms of action. The terms central and peripheral effects are used to distinguish the effects of testosterone on cardiac and extracardiac structures. Central effects include influences on cardiomyocytes and electrophysiology. Peripheral effects include influences on blood vessels, baroreceptor reactivity, skeletal muscles and erythropoesis. Current knowledge about peripheral effects of testosterone may explain much about beneficiary effects in the pathophysiology of HF syndrome. However, central, i.e., cardiac effects of testosterone are to be further explored.
Effects of estrogen on venous function in rats with chronic heart failure
American Journal of Physiology …, 2000
The effect of 17-estradiol on venous function was investigated in ovariectomized rats with heart failure. Rats (50-60 days old) were ovariectomized and implanted with 60-day-release pellets that contain 17-estradiol (1.5 mg) or vehicle. The left coronary artery was ligated 7 days later. Another group of ovariectomized rats was given vehicle pellets and then a sham operation was performed. The rats were studied while under pentobarbital anesthesia at 7 wk after ligation. Ligated rats, relative to sham groups, had lower mean arterial pressure (MAP, Ϫ34 mmHg) and cardiac output (CO, Ϫ38%); higher arterial resistance (R A , ϩ12%) and venous resistance (R V , ϩ116%); mean circulatory filling pressure (MCFP, ϩ40%) and left ventricular end-diastolic pressure (LVEDP, ϩ11 mmHg); and similar cardiovascular responses to norepinephrine (NE). Treatment of ligated rats with 17-estradiol increased CO (ϩ16%); reduced R A (Ϫ16%), R V (Ϫ35%), MCFP (Ϫ23%), and LVEDP (Ϫ3 mmHg); and augmented MAP, R V, and MCFP responses to NE. Therefore, 17-estradiol reduced MCFP, and this reduced preload (LVEDP). 17-Estradiol decreased R V , which, along with decreased R A (afterload), led to an increase in CO. 17-Estradiol likely augmented vasoconstriction to NE through an improvement on the cardiovascular status.
Journal of cardiovascular pharmacology and therapeutics, 2018
Testosterone deficiency is associated with heart failure (HF) progression and poor prognosis. Testosterone therapy has been shown to improve exercise capacity in patients with chronic HF, but no trial has evaluated the impact of replacement in patients with demonstrated testosterone deficiency. Prospective, randomized, double-blind, placebo-controlled, and parallel-group trial comparing testosterone replacement with placebo in males with chronic HF with reduced ejection fraction (HFrEF) and testosterone deficiency (NCT01813201). Long-acting undecanoate testosterone at a fixed dose of 1000 mg was supplied by intramuscular injection at inclusion and then every 3 months. The placebo group received isotonic saline serum. Patients were randomly allocated 1:1 to testosterone or placebo while receiving optimal medical therapy, and the study was conducted for 12 months. The final sample comprised 29 patients, 15 in the placebo group and 14 in the testosterone group (aged 65 ± 8, 62% with an...
Journal of the American College of Cardiology, 2000
OBJECTIVES This study sought to evaluate the effects of postmenopausal estrogen use on mortality in aging women with congestive heart failure (CHF). BACKGROUND The age-related increase in CHF mortality in women may be related to a menopauseassociated increased incidence of coronary artery disease. In addition to inhibiting coronary atherosclerosis, estrogen may also have protective effects on cardiac myocytes independent of the coronary vasculature. We hypothesized that estrogen use is associated with improved survival in elderly women with CHF. METHODS Associations between survival, estrogen use and patient characteristics were assessed in 1,134 women who were at least 50 years of age, had CHF and left ventricular ejection fraction (EF) Յ30% and were enrolled in one of three clinical trials of vesnarinone. RESULTS All-cause 12-month mortality was 15.0% among the 237 estrogen users versus 27.1% among the 897 estrogen nonusers (p ϭ 0.004 for unadjusted comparison of survival). Similar results were observed for cardiac mortality. Regression analysis demonstrated that estrogen use was independently associated with improved survival (relative risk of mortality ϭ 0.68, 95% confidence interval 0.48 to 0.96, p ϭ 0.03). Advanced age, low EF, New York Heart Association class IV CHF, Caucasian race and abnormal serum creatinine, sodium, potassium and transaminase were independently associated with increased mortality. CONCLUSIONS Estrogen use among older women with CHF is associated with decreased overall and cardiac mortality.
Hormonal Replacement and Physical Exercise in Heart Failure Treatment : A Systematic Review
2012
Mailing address: Avenida Jornalista Rubens de Arruda Ramos, 2.354, apto 201 – Centro – 88015-702 – Florianópolis, SC. E-mail: tales@cardiol.br 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 analy...