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[The heart and androgens]
1Service universitaire d'Endocrinologie, CHU Sart-Tilman, 4000 Liège 1, Belgique.
Insights
Male steroids, particularly testosterone, are crucial for cardiovascular health, influencing heart function, inflammation, and vascular resistance. Low testosterone levels are linked to heart disease risk factors, highlighting its clinical importance.
Area of Science:
- Endocrinology and Cardiovascular Physiology
Context:
- Male steroids, beyond sexual function, significantly impact cardiovascular homeostasis.
- Testosterone, via androgen receptors, regulates cardiomyocyte trophicity in health and cardiac disease.
- Androgens modulate inflammatory cytokines (e.g., IL-6, TNF) in heart failure and mediate vascular resistance.
Purpose:
- To explore the multifaceted roles of androgens in cardiovascular physiology and pathology.
- To investigate the link between reduced testosterone levels and pro-atherogenic lipid profiles.
- To underscore the clinical relevance for coronary artery disease (CAD) and heart failure (HF) management.
Summary:
- Testosterone influences cardiomyocyte size and function, impacting both normal physiology and cardiac hypertrophy.
- Reduced free testosterone is associated with adverse lipid profiles (low HDL, high triglycerides), a risk factor for atherosclerosis.
- Androgens play a role in regulating vascular tone and inflammatory responses within the cardiovascular system.
Impact:
- Findings suggest androgens are key players in cardiovascular health and disease, necessitating further research.
- Highlights the clinical implications of assessing testosterone levels in patients with cardiovascular conditions.
- Calls for large-scale studies to evaluate the therapeutic potential of androgens in coronary heart disease and heart failure.
Abstract:
Beyond regulation of sexual function, male steroids play an important role in many physiological homeostasis systems, including the cardiovascular system. Via a specific androgen receptor, testosterone mediates cardiomyocyte trophicity both in physiological situations and in hypertrophy-related cardiac diseases. Androgens also regulate pathological levels of inflammatory cytokines such as Il-6 or TNF in advanced heart failure. They also mediate vascular resistance since coronary vasodilatation has been proven both in vitro and in vivo. Reduced free testosterone serum levels (age-mediated or premature coronary artery disease) promote a pro-atherogenic lipid profile expressed as lower serum HDL-cholesterol and up-regulation of triglyceride levels. This observation has relevant clinical implications for the evaluation and treatment of coronary artery disease. As most of normal and diseased cardiovascular system functions are influenced by androgens, further evaluation of their physiological implications should be undertaken as well as large-scale rigorous studies of the therapeutic implications in two disabling diseases, coronary heart disease and heart failure.
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