Clinical Center Stella Maris, Laboratory of Physiology of Exercise, Strada Rovereta 42, 47891, Falciano, Republic of San Marino.
Heart Fail Rev. 2018 Sep;23(5):773-788. doi: 10.1007/s10741-018-9721-0.
The cardiovascular system is particularly sensitive to androgens, but some controversies exist regarding the effect of testosterone on the heart. While among anabolic abusers, cases of sudden cardiac death have been described, recently it was reported that low serum level of testosterone was correlated with increased risk of cardiovascular diseases (CVD) and mortality rate. This review aims to evaluate the effect of testosterone on myocardial tissue function, coronary artery disease (CAD), and death. Low testosterone level is associated with increased incidence of CAD and mortality. Testosterone administration in hypogonadal elderly men and women has a positive effect on cardiovascular function and improved clinical outcomes and survival time. Although at supraphysiologic doses, androgen may have a toxic effect, and at physiological levels, testosterone is safe and exerts a beneficial effect on myocardial function including mechanisms at cellular and mitochondrial level. The interaction with free testosterone and estradiol should be considered. Further studies are necessary to better understand the interaction mechanisms for an optimal androgen therapy in CVD.
心血管系统对雄激素特别敏感，但关于睾酮对心脏的影响存在一些争议。虽然在合成代谢滥用者中，已经描述了心脏性猝死的病例，但最近有报道称，低血清睾酮水平与心血管疾病 (CVD) 和死亡率的风险增加相关。本综述旨在评估睾酮对心肌组织功能、冠状动脉疾病 (CAD) 和死亡的影响。低睾酮水平与 CAD 发生率和死亡率的增加相关。在性腺功能减退的老年男性和女性中给予睾酮治疗对心血管功能有积极影响，并改善了临床结局和生存时间。尽管在超生理剂量下，雄激素可能具有毒性作用，但在生理水平下，睾酮是安全的，并对心肌功能产生有益影响，包括细胞和线粒体水平的机制。应考虑与游离睾酮和雌二醇的相互作用。需要进一步的研究来更好地了解相互作用机制，以实现 CVD 中的最佳雄激素治疗。
