Circulating Estradiol and Mortality in Men With Systolic Chronic Heart Failure

CONTEXT Androgen deficiency is common in men with chronic heart failure (HF) and is associated with increased morbidity and mortality. Estrogens are formed by the aromatization of androgens; therefore, abnormal estrogen metabolism would be anticipated in HF. OBJECTIVE To examine the relationship bet...

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Published in:JAMA : the journal of the American Medical Association 2009-05, Vol.301 (18), p.1892-1901
Main Authors: Jankowska, Ewa A, Rozentryt, Piotr, Ponikowska, Beata, Hartmann, Oliver, Kustrzycka-Kratochwil, Dorota, Reczuch, Krzysztof, Nowak, Jolanta, Borodulin-Nadzieja, Ludmila, Polonski, Lech, Banasiak, Waldemar, Poole-Wilson, Philip A, Anker, Stefan D, Ponikowski, Piotr
Format: Article
Language:English
Subjects:
Aged
Androgens
Biological and medical sciences
Cardiology. Vascular system
Chronic Disease
Dehydroepiandrosterone Sulfate - blood
Epidemiology
Estradiol - blood
Estrogens
General aspects
Heart
Heart failure
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Failure, Systolic - blood
Heart Failure, Systolic - mortality
Humans
Male
Medical sciences
Mens health
Middle Aged
Mortality
Prognosis
Prospective Studies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Stroke Volume
Survival Rate
Testosterone
Testosterone - blood
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Summary:CONTEXT Androgen deficiency is common in men with chronic heart failure (HF) and is associated with increased morbidity and mortality. Estrogens are formed by the aromatization of androgens; therefore, abnormal estrogen metabolism would be anticipated in HF. OBJECTIVE To examine the relationship between serum concentration of estradiol and mortality in men with chronic HF and reduced left ventricular ejection fraction (LVEF). DESIGN, SETTING, AND PARTICIPANTS A prospective observational study at 2 tertiary cardiology centers (Wroclaw and Zabrze, Poland) of 501 men (mean [SD] age, 58 [12] years) with chronic HF, LVEF of 28% (SD, 8%), and New York Heart Association [NYHA] classes 1, 2, 3, and 4 of 52, 231, 181, and 37, respectively, who were recruited between January 1, 2002, and May 31, 2006. Cohort was divided into quintiles of serum estradiol (quintile 1,
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2009.639