Endocrine Abstracts

Background: Testosterone administration (TA) can improve exercise capacity and glucose metabolism of males patients (pts) with chronic heart failure (CHF). It is not known whether testosterone supplementation benefits only CHF subjects with hypogonadism.

Aim: To compare effects of TA in male pts with CHF with and without testosterone deficiency.

Methods: Fifty-six males patients (median age 64.2±9.6), ejection fraction (EF) 36±9.4, NYHA class II/III (31/25), were enrolled. Of these 38 were randomized to receive TA, intramuscular injection of testosterone undecanoate, every 6 weeks (Nebido, Bayer Shering Germany) and 18 to receive placebo both on top of maximal medical therapy. Treated patients were than divided, according to median value of testosterone, into two groups with Low (LT=14 pt) or high (HT=24 pt) testosterone levels. At baseline and after 12 weeks all patients underwent glycometabolic assessment through HOMA index, cardiopulmonary test, 6-minute walking test (6MWT) and quadriceps maximal isometric and isokinetic strength.

Results: At baseline LT group had a significant lower peak oxygen uptake (VO₂) (−2±0.6; P 0.01) and had shorter exercise time (−2.6±1.3; P 0.04) than HT pts and placebo group. After three months LT group had a significant greater improvement from baseline of peak VO₂ (18% vs 9%; P 0.02), VE/VCO₂ (−14% vs −4%; P 0.01) HOMA index (−16% vs −4%; P 0.03) and maximal isometric strength (19% vs 2%; P 0.03) than HT group. Distance walked at 6MWT and isokinetic strength improved in a similar rate in both LT and HT groups (P>0.05). There was not significant change in any endpoint in the placebo group.

Conclusion: Effects of TA in male with CHF on both exercise capacity and glucose metabolism seem to be greater in those pts with testosterone deficiency.