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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Patients with Heart Failure

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dos Santos, Marcelo Rodrigues [1] ; Carrari Sayegh, Ana Luiza [1] ; Ramalho Groehs, Raphaela Vilar [1] ; Fonseca, Guilherme [1] ; Trombetta, Ivani Credidio [1, 2] ; Pereira Barretto, Antonio Carlos [1] ; Arap, Marco Antonio [3] ; Negrao, Carlos Eduardo [4, 1] ; Middlekauff, Holly R. [5] ; Nunes Alves, Maria-Janieire de Nazare [1]
Total Authors: 10
[1] Univ Sao Paulo, Fac Med, Inst Coracao InCor, Sao Paulo, SP - Brazil
[2] Univ Nove Julho UNINOVE, Sao Paulo, SP - Brazil
[3] Univ Sao Paulo Urol, Fac Med, Sao Paulo, SP - Brazil
[4] Univ Sao Paulo, Escola Educ Fis & Esporte, Sao Paulo, SP - Brazil
[5] Univ Calif Los Angeles, David Geffen Sch Med, Div Cardiol, Los Angeles, CA - USA
Total Affiliations: 5
Document type: Journal article
Source: Arquivos Brasileiros de Cardiologia; v. 105, n. 3, p. 256-264, SEP 2015.
Web of Science Citations: 7

Background: Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown. Objective: We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF. Methods: Total testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients. Results: Length of hospital stay was longer in the LT group compared to in the NT group (37 +/- 4 vs. 25 +/- 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio {[}HR], 2.77; 95% confidence interval {[}CI], 1.58-4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67-8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23-8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 +/- 3 vs. 51 +/- 4 bursts/100 heart beats; p < 0.001). Conclusion: These results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT. (AU)

FAPESP's process: 10/50048-1 - Cellular and functional bases of exercise in cardiovascular diseases
Grantee:Carlos Eduardo Negrão
Support type: Research Projects - Thematic Grants