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Anabolic status and functional impairment in men with mild chronic heart failure

Francisco J Pastor-Pérez1, Sergio Manzano-Fernández, Iris P Garrido Bravo

  • 1Heart Failure Unit, Cardiology Department, University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain. franpastor79@hotmail.com

The American Journal of Cardiology
|July 15, 2011
PubMed

Insights

Hormonal deficiencies, particularly dehydroepiandrosterone sulfate, are linked to exercise intolerance in men with chronic heart failure. Adrenal impairment, not other hormonal axes, independently predicts exercise capacity in these patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Exercise Physiology

Background:

  • Exercise intolerance is a key limitation in chronic heart failure (CHF).
  • Hormonal anabolic deficiencies may contribute to reduced exercise capacity in CHF patients.
  • The specific roles of different hormonal axes in CHF exercise intolerance require further elucidation.

Purpose of the Study:

  • To investigate the association between hormonal anabolic deficiencies and exercise intolerance in men with CHF.
  • To determine which hormonal axis (adrenal, somatotropic, or peripheral) is most significantly related to exercise capacity.

Main Methods:

  • One hundred four men with CHF underwent blood sampling, echocardiography, and cardiopulmonary exercise testing (CPET).
  • Hormonal levels (total testosterone, free testosterone, IGF-1, DHEA-S) were measured.
  • Exercise capacity was assessed by peak oxygen consumption (Vo₂), predicted peak Vo₂, and VE/Vco₂ slope.

Main Results:

  • A high prevalence of hormonal deficiencies was observed, with 61% having dehydroepiandrosterone sulfate (DHEA-S) deficiency.
  • DHEA-S levels significantly correlated with peak Vo₂, predicted peak Vo₂, and VE/Vco₂ slope.
  • Total testosterone, free testosterone, and IGF-1 did not show significant correlations with exercise parameters.
  • Multivariable analysis confirmed DHEA-S as an independent predictor of exercise capacity.

Conclusions:

  • In men with mild CHF, exercise capacity is associated with anabolic impairment of the adrenal axis, specifically DHEA-S.
  • Adrenal hormonal deficiency is a more significant factor in exercise intolerance than deficiencies in the somatotropic or peripheral axes.

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