Testosterone, Hypogonadism, and Heart Failure.

Area of Science:

• Cardiology
• Endocrinology
• Men's Health

Background:

• The link between hypogonadism and cardiovascular disease is established, but its association with chronic heart failure (HF) remains debated.
• Existing studies on testosterone and HF are often heterogeneous and methodologically limited, providing low-quality evidence.
• Male hypogonadism is characterized by low testosterone levels and deficiency symptoms.

Purpose of the Study:

• To critically review studies on testosterone, hypogonadism, and HF.
• To provide clinical guidance on diagnosing and treating male hypogonadism in HF patients.
• To assess the prevalence and clinical significance of testosterone deficiency in men with HF.

Main Methods:

• Systematic review and critical appraisal of published literature.
• Selection of methodologically robust studies for analysis.
• Analysis of correlations between testosterone levels, HF severity, and clinical outcomes.

Main Results:

• Prevalence of testosterone deficiency is significant (30%-50%) in men with HF.
• Low testosterone levels correlate with increased HF severity, reduced exercise capacity, and poorer prognosis.
• Interventional studies suggest potential benefits of testosterone treatment on exercise capacity and cardiac prognosis, though results are inconclusive.

Conclusions:

• Testosterone deficiency is prevalent and clinically relevant in men with HF.
• Clinicians should consider measuring testosterone levels in symptomatic HF patients with predisposing conditions.
• Testosterone replacement therapy may benefit selected hypogonadal men with HF, improving cardiac and systemic outcomes.