Related Experiment Video

Updated: Dec 30, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

6.9K

Hormonal deficiencies in heart failure with preserved ejection fraction: prevalence and impact on diastolic

A M R Favuzzi1, A Venuti, C Bruno

  • 1Division of Internal Medicine and Cardiovascular Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. antonio.mancini@unicatt.it.

European Review for Medical and Pharmacological Sciences
|January 21, 2020
PubMed

Insights

Heart failure with preserved ejection fraction (HFpEF) patients frequently exhibit hormonal deficiencies, impacting cardiac function. These deficiencies, particularly dehydroepiandrosterone-sulfate (DHEA-S) and insulin-like growth factor-1 (IGF-1), correlate with right ventricular dysfunction.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Catabolic mechanisms negatively impact mortality and morbidity in heart failure with reduced ejection fraction.
  • The interplay between anabolic hormonal deficiency, thyroid function, and heart failure with preserved ejection fraction (HFpEF) remains under-investigated.

Purpose of the Study:

  • To determine the prevalence of multi-hormonal deficiencies in HFpEF patients.
  • To investigate the relationship between hormonal deficiencies and echocardiographic indices in HFpEF.

Main Methods:

  • Evaluated plasma levels of N-terminal pro-brain natriuretic peptide, glucose, thyroid hormones, insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone-sulfate (DHEA-S), and testosterone in 40 HFpEF patients.
  • Performed echocardiographic evaluations to assess cardiac function.

Main Results:

  • Nearly all patients (97.5%) had DHEA-S deficiency, 67.5% had IGF-1 deficiency, and 37% had testosterone deficiency.
  • Hormonal deficits were associated with echocardiographic findings such as increased left atrial volume, elevated systolic pulmonary artery pressure (SPAP), and reduced tricuspid annular plane systolic excursion (TAPSE).
  • Low T3 syndrome and subclinical hypothyroidism were also observed; hormonal dysfunction was independent of comorbidities.

Conclusions:

  • Multi-hormonal deficiencies are common in HFpEF patients.
  • These deficiencies are linked to right ventricular dysfunction and diastolic dysfunction.
  • Further research into hormonal replacement therapies may be warranted for HFpEF management.
Abstract

More Related Videos

Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism11:04

Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

Published on: September 1, 2014

11.5K
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs07:09

A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs

Published on: February 18, 2022

2.2K

Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
607
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.6K
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
617
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
746
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
171
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
203