Malkin C, Jones T, Channer K
Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK.
Front Horm Res. 2009;37:183-196. doi: 10.1159/000176053.
Chronic heart failure is common and can be described as a syndrome characterized by impairment of cardiac function associated with a maladaptive metabolic and neurohormonal axis. The thesis that testosterone replacement therapy may be helpful as a treatment for chronic heart failure may seem at first to be unlikely. Testosterone therapy is widely believed to be deleterious to the cardiovascular system and there is a common misconception that the excess of ischaemic heart disease in young and middle-aged males compared to females is a direct effect of endogenous serum testosterone levels. In this chapter we will present the published evidence of the effects of endogenous and therapeutic testosterone on the heart and the human cardiovascular system with an emphasis on the pathologic syndrome of chronic heart failure. There is developing evidence that of all morbid populations, patients with chronic heart failure in particular are likely to benefit from testosterone treatment since the natural history is that of progressive disordered metabolism with catabolic excess and androgen imbalance.
慢性心力衰竭很常见，可被描述为一种以心功能受损为特征的综合征，伴有适应性不良的代谢和神经激素轴。睾酮替代疗法可能有助于治疗慢性心力衰竭这一观点，乍一看似乎不太可能。人们普遍认为睾酮疗法对心血管系统有害，并且存在一种常见的误解，即与女性相比，中青年男性缺血性心脏病发病率较高是内源性血清睾酮水平的直接影响。在本章中，我们将展示已发表的关于内源性和治疗性睾酮对心脏及人类心血管系统影响的证据，重点关注慢性心力衰竭的病理综合征。越来越多的证据表明，在所有患病群体中，尤其是慢性心力衰竭患者可能从睾酮治疗中获益，因为其自然病程是代谢逐渐紊乱，分解代谢过度且雄激素失衡。
