Systolic Heart Failure Clinical Trial
Official title:
Hair Cortisol and Testosterone Levels and Their Correlation With Heart Failure Status in Patients With Chronic Congestive Heart Failure
The purpose of this study is to determine whether hair cortisol and testosterone levels correlate with heart failure status in patient with chronic congestive heart failure.
Progression of chronic congestive heart failure (CHF) is associated with abnormal secretion
of several hormones including glucocorticoids and testosterone.
A single study of patients with chronic heart failure has demonstrated that higher serum
levels of cortisol are independent predictors of increased mortality risk. However, this
study included patients with heart failure who were admitted to the hospital due to other
causes and it might be speculated that the single serum cortisol measurement taken may have
been influenced by the acute illness or by the emotional stress associated with the
admission itself.
Currently, there are several modalities for measuring cortisol levels including serum,
urinary and salivary techniques. However, all these methods represent indicators of acute
cortisol secretion and do not reflect accumulation of the hormone over time. Recently there
has been a growing interest in measuring hair cortisol level. Hair grows approximately 1
centimeter per month and therefore hair analysis accurately reflects long-term endogenous
production of cortisol. This provides for the first time a reliable mode for the measurement
of the accumulation of cortisol over time. We have recently demonstrated higher hair
cortisol levels in patients with acute myocardial infarction compared with controls (the
manuscript has been submitted for publication). Regarding testosterone, several studies have
recently demonstrated lower free serum testosterone levels in patients with heart failure
compared with controls. Furthermore, Serum testosterone levels were inversely correlated
with heart failure status.
The longitudinal assessment of cortisol and testosterone levels over time using the hair
technique may be superior to a single random serum sample for the assessment of chronic
heart failure status and prognosis.
If indeed, hair cortisol and testosterone levels would correlate with heart failure status,
they may be used as a quantitative mode for clinical follow-up of CHF patients (similar to
the role of HbA1C in the follow-up of diabetic patients). However this hypothesis has not
yet been evaluated
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