Relation of Testosterone Levels to Mortality in Men With Heart Failure
Relation of Testosterone Levels to Mortality in Men With Heart Failure
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睾酮水平与男性心力衰竭死亡率的关系
DOI：
10.1016/j.amjcard.2018.01.052
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Takeishi Yasuchika
中科院分区：
文献类型：
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作者：
Yoshihisa Akiomi;Suzuki Satoshi;Sato Yu;Kanno Yuki;Abe Satoshi;Miyata Makiko;Sato Takamasa;Oikawa Masayoshi;Kobayashi Atsushi;Yamaki Takayoshi;Kunii Hiroyuki;Nakazato Kazuhiko;Ishida Takafumi;Takeishi Yasuchika
我们的目的是研究睾酮对心力衰竭（HF）预后的影响，以及潜在的心脏功能，心脏损伤和运动能力。我们分析了连续618名男性HF患者（年龄65.9岁）。根据血清总睾酮（TT）水平将这些患者分为四分位数：第一（TT > 631 ng/dl，n = 154）、第二（462 < TT ≤ 631 ng/dl，n = 155）、第三和第四（TT ≤ 300 ng/dl，n = 153）四分位数。在Kaplan-Meier分析中（平均1，281天），从第一组到第四组，全因死亡率逐渐增加。在多变量考克斯比例风险分析中，发现TT是全因死亡率的独立预测因子（风险比0.929，p = 0.042）。此外，我们还比较了4组之间的超声心动图和心肺运动试验参数，以及B型钠尿肽和心肌肌钙蛋白I的水平。各组间左心室射血分数和B型利钠肽无差异。相反，与第一、第二和第三组相比，第四个四分位数的肌钙蛋白I水平较高，峰值VO 2较低（分别为p <0.05）。血清睾酮水平降低与心力衰竭患者的心肌损伤、运动能力降低和死亡率升高有关。
We aimed to investigate the impact of testosterone on the prognosis of heart failure (HF), as well as the underlying cardiac function, cardiac damage, and exercise capacity. We analyzed consecutive 618 men with HF (age 65.9 years). These patients were divided into quartiles based on their serum levels of total testosterone (TT): first (TT > 631 ng/dl, n = 154), second (462 < TT ≤ 631 ng/dl, n = 155), third (300 < TT ≤ 462 ng/dl, n = 156), and fourth (TT ≤ 300 ng/dl, n = 153) quartiles. In the Kaplan–Meier analysis (mean 1,281 days), all-cause mortality progressively increased throughout from the first to the fourth groups. In the multivariable Cox proportional hazard analysis, TT was found to be an independent predictor of all-cause mortality (hazard ratio 0.929, p = 0.042). In addition, we compared the parameters of echocardiography and cardiopulmonary exercise testing, as well as levels of B-type natriuretic peptide and cardiac troponin I, among the 4 groups. Left ventricular ejection fraction and B-type natriuretic peptide did not differ among the groups. In contrast, the fourth quartile, compared with the first, second, and third groups, had higher levels of troponin I and lower peak VO2(p <0.05, respectively). Decreased serum testosterone is associated with myocardial damage, lower exercise capacity, and higher mortality in men with HF.