Testosterone deficiency in male heart failure patients and its effect on endothelial progenitor cells

Figures & data

Table I.  Baseline characteristics of the study population.

Patients’ characteristics, mean ± SD
Age (years)	61 ± 13
Body weight (kg)	91 ± 17
BMI (kg/m^2)	29 ± 5
Systolic blood pressure (mmHg)	135 ± 21
Diastolic blood pressure (mmHg)	86 ± 13
Comorbidities, % (n)
Hypertension	78% (107)
CAD	44% (61)
Hyperlipidemia	51% (71)
Diabetes	26% (35)
Co-medication, % (n)
Statin	51% (71)
ACE-Inhibitor	75% (103)
β blocker	94% (129)
Aspirin	31% (42)

ACE, angiotensin converting enzyme; BMI, body mass index; CAD, coronary artery disease; SD, standard deviation.

Table II.  Heart failure genesis and laboratory parameters in the study population.

Heart failure characteristics, % (n)
NYHA I	34% (47)
NYHA II	37% (51)
NYHA III	29% (39)
Ischemic cardiomyopathy	33% (46)
Dilated cardiomyopathy	31% (43)
Hypertensive cardiomyopathy	23% (31)
Other genesis	13% (18)
Laboratory values, mean ± SD
Creatinine (mmol/l)	116 ± 73
Cholesterol (mmol/l)	5.0 ± 1.4
LDL-cholesterol (mmol/l)	2.9 ± 1.2
BNP (pg/ml)	485 ± 627
Hemoglobin (g/dl)	14 ± 2
Free testosterone (pmol/l)	33 ± 14

BNP, brain natriuretic peptide; LDL, low density lipoprotein; NYHA, New York heart failure classification.

Table III.  Levels of cytokines and echocardiographic parameters in the two study groups.

	Patients without testosterone deficiency n = 84	Patients with testosterone deficiency n = 53	p value
Cytokines
Adiponectin (ng/ml)	6261.67 (3868.4)	6185.54 (4160.2)	n.s.
VEGF (pg/ml)	37.8 (37.7)	33.87 (25.4)	n.s.
SDF-1 (pg/ml)	3277.5 (593.6)	3193.12 (1091.0)	n.s.
SHBG
SHBG (nmol/ml)	485.61 (243.3)	332.81 (171.2)	0.003
Echocardiographic parameters
IVSd (mm)	12 ± 3	11 ± 3	n.s.
Ejection fraction (%)	39 ± 13	38 ± 11	n.s.
PAP (mmHg + CVP)	27 ± 10	25 ± 10	n.s.
Spiroergometry/ Ergometry (reached wattage)	123 ± 56	138 ± 35	n.s.
VO2 max.(ml/kg/min)	20 ± 6	22 ± 6	n.s.

CVP, central venous pressure; IVSd, intraventricular septum, diastolic; LVEDd, left ventricular diameter, diastolic; PAP, pulmonary arterial pressure; SDF-1, stromal cell derived factor 1; SHBG, sex-hormone-binding globuline; VEGF, vascular endothelial growth factor; VO₂ max, maximal oxygen uptake.

Data are presented as mean ± SD.

Table IV.  Correlation matrix between different clinical parameters in the entire study population.

	Free testosterone	Age	NYHA	Systolic blood pressure	Ejection fraction	Maximum power stage	Maximal oxygen uptake	BNP
Free Testosterone	R^2	−0.317^**	−0.282^**	−0.001	−0.047	0.262^*	0.014	−0.027
	p	0.000	0.001	0.989	0.610	0.030	0.931	0.772
Age	R^2		0.481^**	0.055	−0.071	−0.517^**	−0.286	0.245^**
	p		0.000	0.530	0.437	0.000	0.070	0.007
NYHA	R^2			−0.105	−0.315^**	−0.639^**	−0.702^**	0.333^**
	p			0.238	0.000	0.000	0.000	0.000
Systolic blood pressure	R^2				0.007	−0.030	−0.006	−0.096
	p				0.940	0.806	0.971	0.308
Ejection fraction	R^2					0.306^*	0.595^**	−0.412^**
	p					0.015	0.000	0.000
Maximum power stage	R^2						0.690^**	−0.237
	p						0.000	0.071
Maximal oxygen uptake	R^2							−0.455^**
	p							0.005

R² represents regression coefficients whereas p represents p values.

*The correlation is significant at the p<0.05 level.

**The correlation is significant at the p<0.01 level.

Figure 1.  Endothelial progenitor cell subpopulations detected in patients with chronic heart failure divided with and without testosterone deficiency. Shown subpopulations include A: CD34⁺, B: CD34⁺CD133⁺, C: CD34⁺KDR⁺ and D: CD34⁺CD133⁺KDR⁺. TD, testosterone deficiency. Data presented as mean ± SD.