Q J Med 2000; 93: 689-694
© 2000 Association of Physicians
Commentary papers |
Testosterone: a natural tonic for the failing heart?
From the Department of Cardiology, Royal Hallamshire Hospital 1 Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, Sheffield, UK
Introduction
Chronic congestive heart failure (CHF) remains a significant cause of mortality and morbidity in the UK, accounting for 5% of acute hospital admissions and 1% of the total NHS budget.1 Coronary artery disease (CAD) and hypertension are the most commonly associated conditions. The condition is characterized by left ventricular dysfunction, impaired vascular tone and skeletal muscle abnormalities, producing breathlessness and fatigue. Neuro-hormonal and cytokine activation are self-perpetuating maladaptive responses to the failing heart, which cause further deterioration in cardiac function and increased catabolism.
The mainstay of current therapy includes diuretics and neuro-hormonal manipulation; ACE inhibitors are well established as the most important intervention for improving prognosis, and angiotensin II receptor antagonists offer a good alternative.2 More recently, reduced mortality has been demonstrated from the use of both beta-blockers and the aldosterone receptor antagonist spironolactone.3,4 Vasodilators may also
Gonadal function in men with CHF
Effects on cardiovascular function
Skeletal muscle and strength
Neuro-hormonal activity
Cytokine activation
Conclusion
Notes
References
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