Circulating testosterone and estradiol, autonomic balance and baroreflex sensitivity in middle-aged and elderly men with heart failure

Figures & data

Table 1. Baseline characteristics of the examined men with mild systolic HF.

Variables	Men with HF (n = 46)
Age (years)	62 ± 10
BMI (kg/m^2)	28.9 ± 6.0
NYHA class (I/II) n, (%)	10/36 (22/78)
Aetiology (CAD) n, (%)	33 (72%)
Hypertension (yes)	33 (72%)
DM (yes)	15 (33%)
LVEF (%)	32 ± 8
Haemoglobin (g/dL)	14.4 ± 1.0
hsCRP (mg/L)	1.3 (0.9–3.1)
GFR (mL/min/1.73m^2)	69 ± 16
Na (mEq/L)	142 ± 3
NT-proBNP (pg/mL)	648 (257–946)
Total cholesterol (mg/dL)	192 ± 38
Uric acid, mg/dL	6.9 ± 1.7
Applied treatment
ACE inhibitor and/or ARB, n(%)	41 (89%)
Aldosterone antagonist, n(%)	7 (15%)
β-blocker, n(%)	45 (98%)
Loop diuretic, n(%)	20 (43%)

Data are presented as a mean ± standard deviation, medians with lower and upper quartiles or percentage where appropriate. HF, heart failure; BMI, body mass index; NYHA, New York Heart Association; CAD, coronary artery disease; DM, diabetes mellitus; LVEF, left ventricular ejection fraction; hsCRP, high-sensitivity C-reactive protein; GFR, glomerular filtration rate; NTproBNP, plasma N-terminal pro-B-type natriuretic peptide; ACE, angiotensin converting enzyme; ARB, angiotensin receptor blocker.

Table 2. Serum hormone levels and the prevalence of hormone deficiency and excess in examined men with mild systolic HF.

Variables	Patients with systolic HF (n = 46)	Hormone deficiency (%)	Hormone excess (%)
TT (ng/mL)	5.00 (4.30–5.80)	9	–
eFT (pg/mL)	71 (53–88)	30	–
DHEAS (pg/mL)	558 (96–1214)	47	–
IGF-1 (ng/mL)	114.5 (103.0–141.0)	91	–
SHBG (nmol/L)	46.3 (38.5–57.3)	–	38
E2 (pg/mL)	29.4 (25.1–31.8)	0	0
Cortisol (nmol/L)	613 (517–718)	–	30

Data are presented as a median with lower and upper quartiles and percentage where appropriate; HF – heart failure; TT – total testosterone; eFT – estimated free testosterone; DHEAS – dehydroepiandrosterone sulfate; IGF-1 – insulin-like growth factor type 1; SHBG – seh hormone binding globulin, E₂- oestradiol; Deficiencies of TT, eFT, DHEAS and IGF-1) were defined as ≤the 10th percentile in the corresponding age category in the reference population. SHBG ≥50 nmol/L and cortisol ≥700 nmol/L were interpreted as exceeded values of these hormones.

Table 3. HRV and BRS in examined men with mild systolic HF.

Variables	Mean ± SD	Median(Q1–Q3)
SDNN, ms	36.3 ± 20.2	33.2 (19.2–46.2)
RMSSD, ms	25.3 ± 15.4	24.4 (11.4–33.0)
HRV-VLF, ms^2	653 ± 813	320 (91–878)
HRV-LF, ms^2	207 ± 226	109 (41–296)
HRV-HF, ms^2	181 ± 247	72 (23–210)
HRV-LF/HRV-HF	2.10 ± 1.81	1.45 (0.76–2.35)
BRS-Seq, ms/mmHg	7.8 ± 4.2	6.6 (4.8–10.2)
BRS-Phe, ms/mmHg	4.8 ± 2.5	3.9 (2.9–6.7)

Data are presented as mean with standard deviation and median with higher and lower quartile. SD, standard deviation; q1, lower quartile; q3, upper quartile; SDNN, standard deviation of average R–R intervals; RMSSD, the square root of the mean of the sum of the squares of differences between adjacent R–R intervals; HRV, heart rate variability; VLF, very low frequency; LF, low frequency; HF, high frequency; BRS-Seq, baroreflex assessed using the sequence method; BRS-Phe, baroreflex assessed in the phenylephrine test.

Figure 1. The relation between serum oestradiol and frequency domain of HRV (high frequency) in men with mild systolic HF (0.54, p = 0.006).

Figure 2. The relation between serum testosterone and BRS calculated using the sequence method in men with mild systolic HF (r = 0.52, p = 0.006).

Figure 3. The relation between serum oestradiol and BRS calculated using the phenylephrine method in men with mild systolic HF (0.73, p = 0.001).