Author + information
- Pål Aukrust, MD, PhD⁎ ( and )
- Arne Yndestad, PhD
- ↵⁎Medical Department, Infectious Diseases, Rikshospitalet, Sognsvannsveien 20, Oslo N-0027, Norway
Dr. Handelsman raises concerns with regard to the interpretation of findings in the recently published study by Caminiti et al. (1) and our accompanying editorial (2). His major point is related to testosterone's failure to improve cardiac function while having beneficial peripheral effects—a dichotomy he suggests may be explained by the mood-elevating effects of testosterone. He also raises concerns with regard to the suboptimal use of saline as placebo.
We have no problems with agreeing with Dr. Handelsman's view, and these aspects should be taken into account in the interpretation of the effects of testosterone in heart failure. In fact, the interaction between hormones such as testosterone, neurotransmitters, and inflammatory markers such as cytokines is an attractive target for therapy in several disorders such as chronic heart failure. Thus, if this mechanism contributes to the results of the study by Caminiti et al. (1), it should encourage rather than advise against further studies in this field. Moreover, although the authors did not find any effect on myocardial function, further long-term studies are needed before making any firm conclusions. There is clearly a need for new treatment modalities in heart failure, and testosterone supplementation might be an interesting approach, most probably operating through several mechanisms including those suggested by Dr. Handelsman.
- American College of Cardiology Foundation
- Caminiti G.,
- Volterrani M.,
- Iellamo F.,
- et al.
- Aukrust P.,
- Ueland T.,
- Gullestad L.,
- Yndestad A.