Testosterone May Exert Benefits for Heart Failure

Testosterone supplementation may help improve exercise capacity and metabolic factors in patients with heart failure.  Justin Ezekowitz, from the University of Alberta (Canada), and colleagues completed a meta-analysis of four small, randomized, placebo-controlled trials involving a total of198 patients (84% male, mean age 67 years), with the majority of the patients (71%) having experienced ischemic heart failure.  The data showed that testosterone therapy associated with 16% to 23% relative improvements in walking distance and peak oxygen consumption. Specifically, on average, patients on testosterone walked 54 meters (16.7%) longer on the 6-minute walk test and 46.7 meters (15.9%) longer on the incremental shuttle walk test. Peak oxygen consumption (VO2) improved by 2.70 mL/kg/min (22.7%).  Although there were no effects on left ventricular ejection fraction, the percentage of patients who improved at least on New York Heart Association class was greater with testosterone (35% versus 9.8%).  The researchers noted that there were no major safety concerns, but acknowledged the small sample sizes and short lengths of follow-up.  The study authors conclude that: "Given the unmet clinical needs, testosterone appears to be a promising therapy to improve functional capacity in [heart failure] patients."