Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry
Abstract Aims Testosterone deficiency (TD) is associated with increased morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). However, data in women are scanty. The aim of this study was to investigate the prognostic impact of TD on women with HFrEF. Methods Among 480 pati...
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.14117 |
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| author | Alberto M. Marra Roberta D'Assante Andrea Salzano Massimo Iacoviello Vincenzo Triggiani Giuseppe Rengo Giuseppe Limongelli Daniele Masarone Maria Perticone Antonio Cimellaro Pasquale Perrone Filardi Stefania Paolillo Paola Gargiulo Antonio Mancini Maurizio Volterrani Olga Vriz Roberto Castello Andrea Passantino Michela Campo Pietro A. Modesti Alfredo De Giorgi Michele Arcopinto Anna D'Agostino Valeria Raparelli Andrea M. Isidori Valeria Valente Federica Giardino Giulia Crisci Angela Sciacqua Marcella Savoia Toru Suzuki Eduardo Bossone Antonio Cittadini T.O.S.CA. Investigators |
| author_facet | Alberto M. Marra Roberta D'Assante Andrea Salzano Massimo Iacoviello Vincenzo Triggiani Giuseppe Rengo Giuseppe Limongelli Daniele Masarone Maria Perticone Antonio Cimellaro Pasquale Perrone Filardi Stefania Paolillo Paola Gargiulo Antonio Mancini Maurizio Volterrani Olga Vriz Roberto Castello Andrea Passantino Michela Campo Pietro A. Modesti Alfredo De Giorgi Michele Arcopinto Anna D'Agostino Valeria Raparelli Andrea M. Isidori Valeria Valente Federica Giardino Giulia Crisci Angela Sciacqua Marcella Savoia Toru Suzuki Eduardo Bossone Antonio Cittadini T.O.S.CA. Investigators |
| author_sort | Alberto M. Marra |
| collection | DOAJ |
| description | Abstract Aims Testosterone deficiency (TD) is associated with increased morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). However, data in women are scanty. The aim of this study was to investigate the prognostic impact of TD on women with HFrEF. Methods Among 480 patients prospectively enrolled in the T.O.S.CA. (Terapia Ormonale Scompenso CArdiaco) registry, a prospective, multicentre, nationwide, observational study, 94 women were included in the current analysis. The TD was defined as serum testosterone levels lower than 25 ng/dl. Data regarding clinical status, echocardiography, exercise performance, cardiovascular hospitalization, and survival after an average follow‐up of 36 months were analysed. Results Thirty patients (31.9%) displayed TD. TD was associated with lower tricuspid annular plane excursion (TAPSE) to pulmonary arterial systolic pressure PASP ratio (TAPSE/PASP) (P = 0.008), peak oxygen consumption (VO2 peak) (P = 0.03) and estimated glomerular filtration rate (P < 0.001). TD was an independent predictor of the combined endpoint of all‐cause mortality/cardiovascular hospitalization (HR: 10.45; 95% CI: 3.54–17.01; P = 0.001), all‐cause mortality (HR: 8.33; 95%: 5.36–15.11; P = 0.039), and cardiovascular hospitalization (HR: 2.41; 95% CI: 1.13–4.50; P = 0.02). Conclusions One‐third of women with HFrEF displays TD that impacts remarkably on their morbidity and mortality. TD is associated with a worse clinical profile including exercise capacity, right ventricular‐pulmonary arterial coupling, and renal function. These findings lend support to an accurate profiling of women with HF, a problem often overlooked in clinical trials. |
| first_indexed | 2024-04-10T20:44:40Z |
| format | Article |
| id | doaj.art-5af228fb145a41ae8dfd7268bd1bfdd8 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-10T20:44:40Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-5af228fb145a41ae8dfd7268bd1bfdd82023-01-24T09:02:17ZengWileyESC Heart Failure2055-58222023-02-0110115916610.1002/ehf2.14117Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registryAlberto M. Marra0Roberta D'Assante1Andrea Salzano2Massimo Iacoviello3Vincenzo Triggiani4Giuseppe Rengo5Giuseppe Limongelli6Daniele Masarone7Maria Perticone8Antonio Cimellaro9Pasquale Perrone Filardi10Stefania Paolillo11Paola Gargiulo12Antonio Mancini13Maurizio Volterrani14Olga Vriz15Roberto Castello16Andrea Passantino17Michela Campo18Pietro A. Modesti19Alfredo De Giorgi20Michele Arcopinto21Anna D'Agostino22Valeria Raparelli23Andrea M. Isidori24Valeria Valente25Federica Giardino26Giulia Crisci27Angela Sciacqua28Marcella Savoia29Toru Suzuki30Eduardo Bossone31Antonio Cittadini32T.O.S.CA. InvestigatorsDepartment of Translational Medical Sciences Federico II University Naples ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyIRCCS Synlab SDN S.p.a Naples ItalyCardiology Unit, Department of Medical and Surgical Sciences University of Foggia Foggia ItalyInterdisciplinary Department of Medicine, Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases University of Bari 'A Moro' Bari ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyDivision of Cardiology, Monaldi Hospital, Azienda Ospedaliera dei Colli University of Campania Luigi Vanvitelli Caserta ItalyDivision of Cardiology, Monaldi Hospital, Azienda Ospedaliera dei Colli University of Campania Luigi Vanvitelli Caserta ItalyDepartment of Experimental and Clinical Medicine University Magna Græcia of Catanzaro Catanzaro ItalyDepartment of Medical and Surgical Sciences University Magna Græcia of Catanzaro Catanzaro ItalyDepartment of Advanced Biomedical Sciences Federico II University Naples ItalyDepartment of Advanced Biomedical Sciences Federico II University Naples ItalyDepartment of Advanced Biomedical Sciences Federico II University Naples ItalyDepartment of Medical Sciences IRCCS San Raffaele Pisana Rome ItalyDepartment of Medical Sciences IRCCS San Raffaele Pisana Rome ItalyHeart Center Department King Faisal Hospital & Research Center Riyadh Saudi ArabiaDivision of General Medicine Azienda Ospedaliera Universitaria Integrata Verona ItalyScientific Clinical Institutes Maugeri, IRCCS Pavia ItalyDepartment of Medical and Surgical Sciences, Unit of Endocrinology and Metabolic Diseases University of Foggia Foggia ItalyDipartimento di Medicina Sperimentale e Clinica Università degli Studi di Firenze Florence ItalyDepartment of Medical Sciences, School of Medicine, Pharmacy and Prevention University of Ferrara Ferrara ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyIRCCS Synlab SDN S.p.a Naples ItalyDepartment of Translational Medicine University of Ferrara Ferrara ItalyDepartment of Experimental Medicine Sapienza University of Rome Rome ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyDepartment of Medical and Surgical Sciences University Magna Græcia of Catanzaro Catanzaro ItalyDepartment of Molecular Medicine and Medical Biotechnologies University of Naples Federico II Naples ItalyDepartment of Cardiovascular Sciences University of Leicester, NIHR Biomedical Research Centre, Glenfield Hospital Leicester UKItalian Clinical Outcome Research and Reporting Program (I‐CORRP) Naples ItalyDepartment of Translational Medical Sciences Federico II University Naples ItalyAbstract Aims Testosterone deficiency (TD) is associated with increased morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). However, data in women are scanty. The aim of this study was to investigate the prognostic impact of TD on women with HFrEF. Methods Among 480 patients prospectively enrolled in the T.O.S.CA. (Terapia Ormonale Scompenso CArdiaco) registry, a prospective, multicentre, nationwide, observational study, 94 women were included in the current analysis. The TD was defined as serum testosterone levels lower than 25 ng/dl. Data regarding clinical status, echocardiography, exercise performance, cardiovascular hospitalization, and survival after an average follow‐up of 36 months were analysed. Results Thirty patients (31.9%) displayed TD. TD was associated with lower tricuspid annular plane excursion (TAPSE) to pulmonary arterial systolic pressure PASP ratio (TAPSE/PASP) (P = 0.008), peak oxygen consumption (VO2 peak) (P = 0.03) and estimated glomerular filtration rate (P < 0.001). TD was an independent predictor of the combined endpoint of all‐cause mortality/cardiovascular hospitalization (HR: 10.45; 95% CI: 3.54–17.01; P = 0.001), all‐cause mortality (HR: 8.33; 95%: 5.36–15.11; P = 0.039), and cardiovascular hospitalization (HR: 2.41; 95% CI: 1.13–4.50; P = 0.02). Conclusions One‐third of women with HFrEF displays TD that impacts remarkably on their morbidity and mortality. TD is associated with a worse clinical profile including exercise capacity, right ventricular‐pulmonary arterial coupling, and renal function. These findings lend support to an accurate profiling of women with HF, a problem often overlooked in clinical trials.https://doi.org/10.1002/ehf2.14117Anabolic deficiencyHeart failureHFrEFMultiple hormonal and metabolic deficiency syndromeTestosteroneWomen |
| spellingShingle | Alberto M. Marra Roberta D'Assante Andrea Salzano Massimo Iacoviello Vincenzo Triggiani Giuseppe Rengo Giuseppe Limongelli Daniele Masarone Maria Perticone Antonio Cimellaro Pasquale Perrone Filardi Stefania Paolillo Paola Gargiulo Antonio Mancini Maurizio Volterrani Olga Vriz Roberto Castello Andrea Passantino Michela Campo Pietro A. Modesti Alfredo De Giorgi Michele Arcopinto Anna D'Agostino Valeria Raparelli Andrea M. Isidori Valeria Valente Federica Giardino Giulia Crisci Angela Sciacqua Marcella Savoia Toru Suzuki Eduardo Bossone Antonio Cittadini T.O.S.CA. Investigators Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry ESC Heart Failure Anabolic deficiency Heart failure HFrEF Multiple hormonal and metabolic deficiency syndrome Testosterone Women |
| title | Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry |
| title_full | Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry |
| title_fullStr | Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry |
| title_full_unstemmed | Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry |
| title_short | Testosterone deficiency independently predicts mortality in women with HFrEF: insights from the T.O.S.CA. registry |
| title_sort | testosterone deficiency independently predicts mortality in women with hfref insights from the t o s ca registry |
| topic | Anabolic deficiency Heart failure HFrEF Multiple hormonal and metabolic deficiency syndrome Testosterone Women |
| url | https://doi.org/10.1002/ehf2.14117 |
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