Effect of Long-Acting Testosterone Treatment on Functional Exercise Capacity, Skeletal Muscle Performance, Insulin Resistance, and Baroreflex Sensitivity in Elderly Patients With Chronic Heart Failure
Open accessAbstract
Objectives This study investigated the effect of a 12-week long-acting testosterone administration on maximal exercise capacity, ventilatory efficiency, muscle strength, insulin resistance, and baroreflex sensitivity (BRS) in elderly patients with chronic heart failure (CHF).Background CHF is characterized by a metabolic shift favoring catabolism and impairment in skeletal muscle bulk and function that could be involved in the pathophysiology of heart failure.Methods Seventy elderly patients with stable CHF-median age 70 years, ejection fraction 31.8 +/- 7%-were randomly assigned to receive testosterone (n = 35, intramuscular injection every 6 weeks) or placebo (n = 35), both on top of optimal medical therapy. At baseline and at the end of the study, all patients underwent echocardiogram, cardiopulmonary exercise test, 6-min walk test (6MWT), quadriceps maximal voluntary contraction (MVC), and isokinetic strength (peak torque) and BRS assessment (sequences technique).Results Baseline peak oxygen consumption (VO(2)) and quadriceps isometric strength showed a direct relation with serum testosterone concentration. Peak VO(2) significantly improved in testosterone but was unchanged in placebo. Insulin sensitivity was significantly improved in testosterone. The MVC and peak torque significantly increased in testosterone but not in placebo. The BRS significantly improved in testosterone but not in placebo. Increase in testosterone levels was significantly related to improvement in peak VO(2) and MVC. There were no significant changes in left ventricular function either in testosterone or placebo.Conclusions These results suggest that long-acting testosterone therapy improves exercise capacity, muscle strength, glucose metabolism, and BRS in men with moderately severe CHF. Testosterone benefits seem to be mediated by metabolic and peripheral effects.
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A 12-week long-acting testosterone administration increases quadriceps isometric strength, maximal voluntary contraction, and isokinetic strength.
“A study investigating the effect of a 12-week long-acting testosterone administration on maximal exercise capacity and muscle strength found an increase in quadriceps isometric strength, maximal voluntary contraction, and isokinetic strength (peak torque) (12).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [12]
Changes in fat mass, lean body mass, and muscle strength occur within 12-16 weeks of testosterone treatment.
“Changes in fat mass, lean body mass, and muscle strength occur within 12–16 weeks, stabilize at 6–12 months, but can marginally continue over years.”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [12]
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- Authors
- Caminiti, G., Volterrani, M., Iellamo, F., Marazzi, G., Massaro, R., Miceli, M., Mammi, C., Piepoli, M., Fini, M., & Rosano, G. M. C.
- Affiliations
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- University of Rome Tor Vergata (IT)
- Guglielmo da Saliceto Hospital (IT)
- Corresponding author
- Iellamo, Ferdinando
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2009-09
- Volume
- 54
- Issue
- 10
- Pages
- 919-927
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W176571599
- Cited by
- 444
- References
- 51
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 12 · 2023: 13 · 2022: 24 · 2021: 28 · 2020: 28 · 2019: 23 · 2018: 25 · 2017: 24 · 2016: 29 · 2015: 34 · 2014: 48 · 2013: 27 · 2012: 31
- FWCI
- 25.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- testosterone replacement therapy, chronic heart failure, older men, exercise capacity, skeletal muscle strength, insulin resistance, baroreflex sensitivity, peak oxygen uptake, ventilatory efficiency, left ventricular function
- MeSH terms
- Aged, Blood Glucose, Chronic Disease, Double-Blind Method, Echocardiography, Exercise Test, Heart Failure, Humans, Injections, Intramuscular, Insulin Resistance, Leg, Male, Oxygen Consumption, Testosterone, Ventricular Function, Left, Exercise Tolerance, Baroreflex, Muscle, Skeletal, Testosterone Congeners, Muscle Strength
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