The age-related decline of circulating anabolic hormones in male is associated with increased morbidity and mortality. It has been reported that anabolic deficiency is associated with cachexia in patients with heart failure (HF). Thus, we aimed to investigate the impact of testosterone on cardiac function and exercise capacity. We analyzed consecutive 618 male patients with HF (age 65.9 years), who admitted to our hospital. These patients were divided into 4 groups based on the serum levels of total testosterone (TT): 1st (TT >631 ng/dl, n = 154), 2nd (462 < TT <631 ng/dl, n = 155), 3rd (300 < TT <462 ng/dl, n = 156) and 4th (TT <300 ng/dl, n = 153) quartiles. We compared parameters of echocardiography and cardiopulmonary exercise testing, and plasma levels of cardiac troponin I among the four groups. Left ventricular ejection fraction, right ventricular fractional area change, B-type natriuretic peptide did not differ among the four groups. In contrast, the 4th quartile, compared to 1st, 2nd and 3rd groups, had higher levels of troponin I and lower peak VO2 (troponin I, 57.4 vs. 21.4, 21.7, 33.4 pg/ml, P < .01; peak VO2 14.5 vs. 16.4, 15.8, 16.5 ml/kg/min, P < .05). Lower serum testosterone is associated with myocardial damage and lower exercise capacity in male patients with heart failure.
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