title: Low serum testosterone as a new risk factor for chronic rejection in heart transplanted men.
abstract: BACKGROUND
  Among the various complications of heart transplantation (HTx), the vasculopathy of the allograft (CAV), a phenomenon of chronic rejection, is still a serious problem. Recently, the literature has shown that low testosterone levels in men are associated with cardiovascular disease. In this study, we evaluated the influence of testosterone plasma levels on CAV development.
  
  
  METHODS
  We studied, with a prospective observational study, all consecutive male HTx patients evaluated from May 2010 to June 2011 at our center. All subjects underwent accurate medical history collection, physical examination, biochemical blood tests, hormone levels, transthoracic Doppler echocardiography, coronary flow velocity reserve assessment, and coronary angiogram.
  
  
  RESULTS
  HTx subjects with CAV had significant lower total testosterone plasma levels (12.9±3.9 vs. 15.8±5.8 nmol/L), free testosterone (0.26±0.07 vs. 0.31±0.08 nmol/L), and coronary flow velocity reserve (2.35±0.60 vs. 2.81±0.78 s) with respect to No-CAV patients. Considering the patients as a whole group, a significant negative relation was found between free and total testosterone plasma levels and some cardiovascular risk factors (cholesterol and fasting blood glucose). A significant linear inverse relation was found between total and free testosterone plasma levels and CAV grading. Only free testosterone plasma levels were independent predictors for CAV.
  
  
  CONCLUSIONS
  We showed for the first time the influence of testosterone plasma levels on CAV development: indirectly increasing traditional risk factors and directly with a probable influence on alloimmune response.
authors.affiliation: Department of Molecular Medicine, Centre for Human Reproduction Pathology, University of Padova, Padova, Italy. ncaretta@gmail.com
authors.forename: Nicola
authors.initials: N
authors.lastname: Caretta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Feltrin
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.forename: Chiara
authors.initials: C
authors.lastname: D'Agostino
authors.forename: Francesco
authors.initials: F
authors.lastname: Tona
authors.forename: Riccardo
authors.initials: R
authors.lastname: Selice
authors.forename: Tony
authors.initials: T
authors.lastname: Krajcar
authors.forename: Nadia
authors.initials: N
authors.lastname: Minicuci
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Carlo
authors.initials: C
authors.lastname: Foresta
mesh_terms: D000368:Aged; D002908:Chronic Disease; D006084:Graft Rejection / Q000209:etiology*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*; D014652:Vascular Diseases / Q000209:etiology*
chemical_list: D013739:Testosterone