Dr Julia Grant1, Dr Sarah Alexander2,3, Dr Thomas Marwick3,4, Dr Rakibul Islam1, Dr Erin Howden2,3, Professor Susan Davis1
1School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia, 2Cardiometabolic Health and Exercise Physiology, Baker Heart and Diabetes Institute, Melbourne, Australia, 3Department of Cardiometabolic Health, The University of Melbourne, Melbourne, Australia, 4Imaging Research, Baker Heart and Diabetes Institute, Melbourne, Australia
Biography:
Dr Julia Grant is a medical practitioner and physiotherapist with extensive experience in the areas of paediatrics, critical care and women’s health. She is Head of Clinical Trials at the Women’s Health Research Program at Monash University. Julia is a current PhD candidate and is investigating the potential role for exogenous testosterone across a variety of diseases that disproportionately affect women.
Aims:
Testosterone exerts beneficial vascular and muscle effects. Our study aim was to determine whether testosterone improves exercise capacity in postmenopausal women with stage B heart failure (SBHF), and thus potentially prevent progression to symptomatic disease.
Methods:
In this single-centre, double-blind, randomised, placebo-controlled crossover trial of females aged ≥55 years with SBHF and reduced exercise capacity, participants were randomly allocated to transdermal testosterone 5 mg/day or identical placebo for four months. After a four-week washout, they were crossed over. The primary outcome was change in cardiorespiratory fitness, measured by V̇O2peak. Secondary outcomes included changes to cardiac structure and function assessed by echocardiography and cardiac magnetic resonance imaging, and quality of life.
Results:
Thirty-eight participants (median age 72, range 60-80 years; median BMI: 33.2 kg/m2 (IQR 28.7-35.9)) completed the study. Testosterone had no significant effect on V̇O2peak (β=-0.05, 95% CI-0.74-0.65), indices of cardiac function, or quality of life. An adjusted exploratory analysis revealed a modest testosterone effect on left ventricular mass (β=5.66, 95% CI 3.47-7.85, p<0.001) and left ventricular mass index (β=2.81, 95% CI 1.77-3.84, p<0.001).
Conclusions:
Transdermal testosterone did not improve exercise capacity in postmenopausal females with SBHF. The LV mass effects, although not clinically meaningful, warrant further study.