Effects of testosterone on coronary vasomotor regulation in men with coronary heart disease

The increased incidence of coronary artery disease in men compared with premenopausal women suggests a detrimental role of male hormones on the cardiovascular system. However, testosterone has direct relaxing effects on coronary arteries in animals, as shown both in vitro and in vivo. The effect of...

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Published in:Circulation (New York, N.Y.) N.Y.), 1999-10, Vol.100 (16), p.1690-1696
Main Authors: WEBB, C. M, MCNEILL, J. G, HAYWARD, C. S, DE ZEIGLER, D, COLLINS, P
Format: Article
Language:English
Subjects:
Acetylcholine - administration & dosage
Acetylcholine - pharmacology
Adult
Aged
Analysis of Variance
Biological and medical sciences
Blood Pressure - drug effects
Cardiology. Vascular system
Coronary Angiography - drug effects
Coronary Circulation - drug effects
Coronary Circulation - physiology
Coronary Disease - physiopathology
Coronary heart disease
Coronary Vessels - drug effects
Coronary Vessels - physiopathology
Female
Heart
Heart Rate - drug effects
Hemodynamics - drug effects
Hemodynamics - physiology
Humans
Hypercholesterolemia
Infusions, Intra-Arterial
Male
Medical sciences
Middle Aged
Muscle, Smooth, Vascular - drug effects
Muscle, Smooth, Vascular - physiopathology
Sex Characteristics
Smoking
Testosterone - administration & dosage
Testosterone - pharmacology
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Summary:The increased incidence of coronary artery disease in men compared with premenopausal women suggests a detrimental role of male hormones on the cardiovascular system. However, testosterone has direct relaxing effects on coronary arteries in animals, as shown both in vitro and in vivo. The effect of testosterone on the human coronary circulation remains unknown. We studied 13 men (aged 61+/-11 years) with coronary artery disease. They underwent measurement of coronary artery diameter and blood flow after a 3-minute intracoronary infusion of vehicle control (ethanol) followed by 2-minute intracoronary infusions of acetylcholine (10(-7) to 10(-5) mol/L) until peak velocity response. A dose-response curve to 3-minute infusions of testosterone (10(-10) to 10(-7) mol/L) was then determined, and the acetylcholine infusions were repeated. Finally, an intracoronary bolus of isosorbide dinitrate (1000 microgram) was given. Coronary blood flow was calculated from measurements of blood flow velocity using intracoronary Doppler and coronary artery diameter using quantitative coronary angiography. Testosterone significantly increased coronary artery diameter compared with baseline (2.78+/-0. 74 mm versus 2.86+/-0.72 mm [P=0.05], 2.87+/-0.71 mm [P=0.038], and 2.90+/-0.75 mm [P=0.005] for baseline versus testosterone 10(-9) to 10(-7) mol/L, respectively). A significant increase in coronary blood flow occurred at all concentrations of testosterone compared with baseline (geometric mean [95% CI]: 32 [25, 42] versus 36.3 [27, 48] (P=0.006), 35.3 [26, 47] (P=0.029), 36.8 [28, 49] (P=0.002), and 37 [28, 48] (P=0.002), mL/min for baseline versus testosterone 10(-10) to 10(-7) mol/L, respectively). No differences existed in coronary diameter or blood flow responses to acetylcholine before versus after testosterone. Short-term intracoronary administration of testosterone, at physiological concentrations, induces coronary artery dilatation and increases coronary blood flow in men with established coronary artery disease.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.100.16.1690