De Smet M A J, Lapauw B, De Backer T
Department of Internal Medicine, Ghent University, Ghent, Belgium.
Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.
Andrologia. 2017 Mar;49(2). doi: 10.1111/and.12610. Epub 2016 May 2.
The prevalence of testosterone substitution as well as of androgen deprivation therapy in men is increasing. This review aims to summarise available knowledge of the effects of sex steroids on cardiac structure and function in men. MEDLINE was searched through PubMed. Original studies, systematic reviews and meta-analyses, and relevant citations were screened. A short-term hormonal intervention study in healthy young men with respect to echocardiographic parameters of structure and function was performed. Preclinical research provides sufficient evidence for the heart as a substrate for sex hormones. In animals, administration of oestradiol appears to have beneficial effects on cardiac structure and function, whereas administration of testosterone to noncastrated animals adversely affects cardiac function. However, the effects of sex steroids on cardiac function and structure appear more heterogeneous in human observational studies while comparative, prospective studies in humans are lacking. It is concluded that although effects of testosterone substitution as well as of androgen deprivation on cardiac structure and function can be expected based on pre-clinical research, there exists an important knowledge gap of the effects of hormonal intervention in men. As such, there is a need to address this question in future prospective intervention trials.
男性中睾酮替代疗法以及雄激素剥夺疗法的应用正在增加。本综述旨在总结关于性类固醇对男性心脏结构和功能影响的现有知识。通过PubMed检索MEDLINE。筛选原始研究、系统评价和荟萃分析以及相关参考文献。对健康年轻男性进行了一项关于心脏结构和功能超声心动图参数的短期激素干预研究。临床前研究为心脏作为性激素作用靶点提供了充分证据。在动物中，给予雌二醇似乎对心脏结构和功能有有益影响，而给未阉割动物注射睾酮则会对心脏功能产生不利影响。然而，在人类观察性研究中，性类固醇对心脏功能和结构的影响似乎更为复杂多样，且缺乏人类的比较性前瞻性研究。结论是，尽管基于临床前研究可以预期睾酮替代疗法以及雄激素剥夺对心脏结构和功能的影响，但在激素干预对男性影响方面仍存在重要的知识空白。因此，有必要在未来的前瞻性干预试验中解决这个问题。
