Key result
HFpEF is linked to over double the prevalence of testosterone deficiency versus HFrEF.
Why the study?
While anabolic hormone deficit is common in HFrEF, few data are available regarding anabolic hormone deficiencies in HFpEF and their correlation with antioxidant capacity.
Are anabolic hormone deficiencies present in HFpEF and do they correlate with total antioxidant capacity compared to HFrEF?
Cross-Sectional (n=50)
Are anabolic hormone deficiencies present in HFpEF and do they correlate with total antioxidant capacity compared to HFrEF?
Absolute Event Rate: 72% vs 32%
p-value: p=<0.05
Anabolic hormone deficiencies, particularly testosterone and DHEA-S, are highly prevalent in HFpEF and correlate with total antioxidant capacity, suggesting different pathophysiological mechanisms compared to HFrEF.
Testosterone deficiency appears more prevalent in HFpEF than HFrEF; hypothesis-generating for distinct mechanisms, should not yet change practice.
Background. While anabolic hormone deficit is a common finding in heart failure with reduced ejection fraction (HFrEF), few data are available in heart failure with preserved ejection fraction (HFpEF). Methods. Blood samples were collected for metabolic (total cholesterol, HDL cholesterol, LDL cholesterol, creatinine, and glucose) and hormonal (IGF-1, DHEA-S, TSH, fT3, fT4, and T) determination, comparing 30 patients with HFpEF and 20 patients with HFrEF. Total antioxidant capacity was evaluated by using the spectrophotometric method using the latency time in the appearance of the radical species of a chromogen (LAG, sec) as a parameter proportional to antioxidant content of the sample. Echocardiographic parameters were also assessed in the two groups. Results. A high prevalence of testosterone (32% in HFrEF and 72% in HFpEF, p<0.05 ) and DHEA-S deficiencies was observed in HFpEF patients. Echocardiographic parameters did not correlate with hormone values. A significant direct correlation between T (r2 = 0.25, p<0.05 ) and DHEA-S (r2 = 0.19, p<0.05 ) with LAG was observed only in HFpEF. Conclusion. Anabolic hormone deficiency is clearly shown in HFpEF, as already known in HFrEF. Although longitudinal studies are required to confirm the prognostic value of this observation, our data suggest different mechanisms in modulating antioxidants in the two conditions, with possible therapeutic implications.
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Mancini et al. (2020) conducted a cross-sectional in Heart failure with reduced or preserved ejection fraction (n=50). Heart failure with preserved ejection fraction (HFpEF) vs. Heart failure with reduced ejection fraction (HFrEF) was evaluated on Prevalence of testosterone deficiency (p=<0.05). Heart failure with preserved ejection fraction was associated with a higher prevalence of testosterone deficiency compared to reduced ejection fraction (72% vs 32%, p<0.05).
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