Abstract 2372: Clinical And Metabolic Effects Of Six Months Testosterone Treatment In Elderly Female Patients With Chronic Heart Failure

Abstract

Background: Patients with chronic heart failure (CHF) show muscle mass wasting and decreased exercise capacity. Testosterone supplementation improves several clinical and metabolic parameters in male CHF subjects. No studies have evaluated the effects of long-term testosterone administration on female patients with CHF. Aim: To assess the effect of a 6 months testosterone administration on exercise capacity, muscle strength, and insulin resistance in female patients with advanced CHF. Methods: Thirty-two elderly female patients (pts) with stable CHF, mean age 68,6 ± 7, ejection fraction 32,9 ± 6, NYHA class III, were enrolled. Of these, 20 were randomized to receive testosterone therapy (T) (through transdermal patch) and 12 to receive placebo (P), both on top of maximal medical therapy. At baseline, at three and after 6 months patients underwent echocardiogram, cardiopulmonary test, 6-minute walking test (6MWT), quadriceps maximal isometric voluntary contraction(MVC) and peaktorque (PT) and HOMA index assesment. Results: VO2 and distance walked at 6MWT significantly improved in T group from baseline both at three (+20%; +36% respectively) and six months (+28%; 41% respectively) while were unchanged in the P group. At six months Patients of T group had a significantly higher increase of both MVC and PT than P group. HOMA-R was significantly reduced (− 15% vs +5%; p < 0.05) and HDL-cholesterol levels were increased (+22% vs p < 0.05).in T group respect to P. NYHA class improved (from III to II) in 7/20 pts of T group and 2/12 of P group. Increase in free testosterone levels were significantly related to improvement in VO2 peak (r 0,42; p 0.032). No significant echocardiographic changes were observed in both groups. No side effects were observed. Two patients of both group were hospitalizes for HF recurrence. Conclusion: Testosterone supplementation improves exercise tolerance, muscle strength, and insulin resistance in women with advanced CHF. Testosterone seem to be an effective and safe therapy for CHF elderly female subjects.