Skip to main content
Top
Published in: International Urology and Nephrology 7/2019

01-07-2019 | Prostate Cancer | Urology - Original Paper

Androgen-deprivation therapy impairs left ventricle functions in prostate cancer patients

Authors: Batur Gonenc Kanar, Beste Ozben, Murat Sunbul, Emre Şener, Onur Ozkan, Ilker Tınay, Mustafa Kursat Tigen

Published in: International Urology and Nephrology | Issue 7/2019

Login to get access

Abstract

Background

Androgen-deprivation therapy (ADT) is a treatment option for locally advanced and metastatic prostate cancer (PCA). The aim of the study was to evaluate the effect of ADT on left ventricular (LV) functions assessed by speckle-tracking echocardiography (STE) in prostate cancer (PCA) patients.

Methods

Forty-nine consecutive PCA patients (mean age 71.5 ± 6.7 years) who would be treated with radiotherapy and ADT and 32 consecutive PCA patients (mean age 71.9 ± 7.0 years) who would be treated with radical or partial prostatectomy and 42 age-matched healthy men (mean age 70.5 ± 9.1 years) were included in our study. The left ventricular functions were assessed by both conventional echocardiography and STE at baseline and 6 months later.

Results

There were not any significant difference in characteristics of the patients and controls. There were not any significant differences in conventional echocardiographic measures at baseline and at 6th month among the PCA patients and controls. Although there were not any significant differences in STE measures at baseline among the PCA patients and controls, the strain measures of the PCA patients receiving ADT decreased significantly at the 6th month and were significantly lower compared to strain measures of PCA patients undergoing prostatectomy and controls. There was not any statistically significant difference in baseline and 6th-month strain measures of the PCA patients undergoing prostatectomy.

Conclusions

ADT might be associated with decrease in LV longitudinal, circumferential, and radial strain measures in patients with PCA. STE might be useful for early identification of LV subclinical impairment in PCA patients treated with ADT.
Literature
1.
go back to reference Čulić V (2015) Androgens in cardiac fibrosis and other cardiovascular mechanisms. Int J Cardiol 20(179):190–192CrossRef Čulić V (2015) Androgens in cardiac fibrosis and other cardiovascular mechanisms. Int J Cardiol 20(179):190–192CrossRef
2.
go back to reference Oskui PM, French WJ, Herring MJ, Mayeda GS, Burstein S, Kloner RA (2013) Testosterone and the cardiovascular system: a comprehensive review of the clinical literature. J Am Heart Assoc 15:e000272 Oskui PM, French WJ, Herring MJ, Mayeda GS, Burstein S, Kloner RA (2013) Testosterone and the cardiovascular system: a comprehensive review of the clinical literature. J Am Heart Assoc 15:e000272
3.
go back to reference Toma M, McAlister FA, Coglianese EE, Vidi V, Vasaiwala S, Bakal JA, Armstrong PW, Ezekowitz JA (2012) Testosterone supplementation in heart failure: a meta-analysis. Circ Heart Fail 5:315–321CrossRefPubMed Toma M, McAlister FA, Coglianese EE, Vidi V, Vasaiwala S, Bakal JA, Armstrong PW, Ezekowitz JA (2012) Testosterone supplementation in heart failure: a meta-analysis. Circ Heart Fail 5:315–321CrossRefPubMed
4.
5.
go back to reference Araujo AB, Dixon JM, Suarez EA, Murad MH, Guey LT, Wittert GA (2011) Clinical review: endogenous testosterone and mortality in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 96(10):3007–3019CrossRefPubMedPubMedCentral Araujo AB, Dixon JM, Suarez EA, Murad MH, Guey LT, Wittert GA (2011) Clinical review: endogenous testosterone and mortality in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 96(10):3007–3019CrossRefPubMedPubMedCentral
6.
go back to reference Malkin CJ, Pugh PJ, Morris PD, Asif S, Jones TH, Channer KS (2010) Low serum testosterone and increased mortality in men with coronary heart disease. Heart 96:1821–1825CrossRefPubMed Malkin CJ, Pugh PJ, Morris PD, Asif S, Jones TH, Channer KS (2010) Low serum testosterone and increased mortality in men with coronary heart disease. Heart 96:1821–1825CrossRefPubMed
7.
go back to reference Hassan NA, Salem MF, Sayed MA (2009) Doping and effects of anabolic androgenic steroids on the heart: histological, ultrastructural, and echocardiographic assessment in strength athletes. Hum Exp Toxicol 28:273–283CrossRefPubMed Hassan NA, Salem MF, Sayed MA (2009) Doping and effects of anabolic androgenic steroids on the heart: histological, ultrastructural, and echocardiographic assessment in strength athletes. Hum Exp Toxicol 28:273–283CrossRefPubMed
8.
go back to reference D’Andrea A, Caso P, Salerno G, Scarafile R, De Corato G, Mita C, Di Salvo G, Severino S, Cuomo S, Liccardo B, Esposito N, Calabrò R (2007) Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis. Br J Sports Med 41:149–155CrossRefPubMed D’Andrea A, Caso P, Salerno G, Scarafile R, De Corato G, Mita C, Di Salvo G, Severino S, Cuomo S, Liccardo B, Esposito N, Calabrò R (2007) Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis. Br J Sports Med 41:149–155CrossRefPubMed
10.
go back to reference Kokontis JM, Liao S (1999) Molecular action of androgen in the normal and neoplastic prostate. Vitam Horm 55:219–307CrossRefPubMed Kokontis JM, Liao S (1999) Molecular action of androgen in the normal and neoplastic prostate. Vitam Horm 55:219–307CrossRefPubMed
11.
go back to reference Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N, European Association of Urology (2014) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol 65:467–479CrossRefPubMed Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N, European Association of Urology (2014) EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol 65:467–479CrossRefPubMed
12.
go back to reference Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E, Middleton R, Porterfield H, Sharp SA, Smith TJ, Taplin ME, Vogelzang NJ, Wade JL Jr, Bennett CL, Scher HI, American Society of Clinical Oncology (2004) American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol 22:2927–2941CrossRefPubMed Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E, Middleton R, Porterfield H, Sharp SA, Smith TJ, Taplin ME, Vogelzang NJ, Wade JL Jr, Bennett CL, Scher HI, American Society of Clinical Oncology (2004) American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol 22:2927–2941CrossRefPubMed
13.
go back to reference Melloni C, Roe MT (2019) Androgen deprivation therapy and cardiovascular disease. Urol Oncol 19:1078–1439 Melloni C, Roe MT (2019) Androgen deprivation therapy and cardiovascular disease. Urol Oncol 19:1078–1439
14.
go back to reference Gupta D, Salmane C, Slovin S, Steingart RM (2017) Cardiovascular complications of androgen deprivation therapy for prostate cancer. Curr Treat Options Cardiovasc Med 19:61–68CrossRefPubMed Gupta D, Salmane C, Slovin S, Steingart RM (2017) Cardiovascular complications of androgen deprivation therapy for prostate cancer. Curr Treat Options Cardiovasc Med 19:61–68CrossRefPubMed
15.
go back to reference Voog JC, Paulus R, Efstathiou JA (2016) Reply from Authors re: Ronald C. Chen. Decisions regarding whether to use androgen deprivation therapy with radiotherapy in prostate cancer: is cardiovascular mortality the most relevant outcome? Outcomes for favorable and unfavorable intermediate risk prostate cancer patients receiving radiation therapy with or without short-term androgen deprivation therapy. Eur Urol 69:212–213CrossRefPubMed Voog JC, Paulus R, Efstathiou JA (2016) Reply from Authors re: Ronald C. Chen. Decisions regarding whether to use androgen deprivation therapy with radiotherapy in prostate cancer: is cardiovascular mortality the most relevant outcome? Outcomes for favorable and unfavorable intermediate risk prostate cancer patients receiving radiation therapy with or without short-term androgen deprivation therapy. Eur Urol 69:212–213CrossRefPubMed
16.
go back to reference Yoshihisa A, Suzuki S, Sato Y, Kanno Y, Abe S, Miyata M, Sato T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y (2018) Relation of testosterone levels to mortality in men with heart failure. Am J Cardiol 121:1321–1327CrossRefPubMed Yoshihisa A, Suzuki S, Sato Y, Kanno Y, Abe S, Miyata M, Sato T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y (2018) Relation of testosterone levels to mortality in men with heart failure. Am J Cardiol 121:1321–1327CrossRefPubMed
17.
go back to reference Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–270CrossRefPubMed Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–270CrossRefPubMed
18.
go back to reference Nagueh SF, Smiseth OA, Appleton CP et al (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 17:1321–1360CrossRefPubMed Nagueh SF, Smiseth OA, Appleton CP et al (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 17:1321–1360CrossRefPubMed
19.
go back to reference Mądry W, Karolczak MA (2016) Physiological basis in the assessment of myocardial mechanics using speckle-tracking echocardiography 2D. Part I. J Ultrason 16:135–144CrossRefPubMedPubMedCentral Mądry W, Karolczak MA (2016) Physiological basis in the assessment of myocardial mechanics using speckle-tracking echocardiography 2D. Part I. J Ultrason 16:135–144CrossRefPubMedPubMedCentral
20.
go back to reference Cameli M, Mondillo S, Galderisi M, Mandoli GE, Ballo P, Nistri S, Capo V, D’Ascenzi F, D’Andrea A, Esposito R, Gallina S, Montisci R, Novo G, Rossi A, Mele D, Agricola E (2017) Speckle tracking echocardiography: a practical guide. G Ital Cardiol (Rome) 18:253–269 Cameli M, Mondillo S, Galderisi M, Mandoli GE, Ballo P, Nistri S, Capo V, D’Ascenzi F, D’Andrea A, Esposito R, Gallina S, Montisci R, Novo G, Rossi A, Mele D, Agricola E (2017) Speckle tracking echocardiography: a practical guide. G Ital Cardiol (Rome) 18:253–269
21.
go back to reference Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, Pedri S, Ito Y, Abe Y, Metz S, Song JH, Hamilton J, Sengupta PP, Kolias TJ, d’Hooge J, Aurigemma GP, Thomas JD, Badano LP (2015) Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. J Am Soc Echocardiogr 28:183–193CrossRefPubMed Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, Pedri S, Ito Y, Abe Y, Metz S, Song JH, Hamilton J, Sengupta PP, Kolias TJ, d’Hooge J, Aurigemma GP, Thomas JD, Badano LP (2015) Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. J Am Soc Echocardiogr 28:183–193CrossRefPubMed
22.
go back to reference Sugimoto T, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Akhaladze N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Moonen M, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, von Bardeleben RS, Vinereanu D, Zamorano JL, Go YY, Rosca M, Calin A, Magne J, Cosyns B, Marchetta S, Donal E, Habib G, Galderisi M, Badano LP, Lang RM, Lancellotti P (2017) Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 18:833–840CrossRefPubMed Sugimoto T, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Akhaladze N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Moonen M, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, von Bardeleben RS, Vinereanu D, Zamorano JL, Go YY, Rosca M, Calin A, Magne J, Cosyns B, Marchetta S, Donal E, Habib G, Galderisi M, Badano LP, Lang RM, Lancellotti P (2017) Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 18:833–840CrossRefPubMed
23.
go back to reference Ayaz O, Banga S, Heinze-Milne S, Rose RA, Pyle WG, Howlett SE (2019) Long-term testosterone deficiency modifies myofilament and calcium-handling proteins and promotes diastolic dysfunction in the aging mouse heart. Am J Physiol Heart Circ Physiol 316:768–780CrossRef Ayaz O, Banga S, Heinze-Milne S, Rose RA, Pyle WG, Howlett SE (2019) Long-term testosterone deficiency modifies myofilament and calcium-handling proteins and promotes diastolic dysfunction in the aging mouse heart. Am J Physiol Heart Circ Physiol 316:768–780CrossRef
24.
go back to reference Kang NN, Fu L, Xu J, Han Y, Cao JX, Sun JF, Zheng M (2012) Testosterone improves cardiac function and alters angiotensin II receptors in isoproterenol-induced heart failure. Arch Cardiovasc Dis 105:68–76CrossRefPubMed Kang NN, Fu L, Xu J, Han Y, Cao JX, Sun JF, Zheng M (2012) Testosterone improves cardiac function and alters angiotensin II receptors in isoproterenol-induced heart failure. Arch Cardiovasc Dis 105:68–76CrossRefPubMed
25.
go back to reference Curl CL, Delbridge LM, Canny BJ, Wendt IR (2009) Testosterone modulates cardiomyocyte Ca(2+) handling and contractile function. Physiol Res 58:293–297PubMed Curl CL, Delbridge LM, Canny BJ, Wendt IR (2009) Testosterone modulates cardiomyocyte Ca(2+) handling and contractile function. Physiol Res 58:293–297PubMed
26.
go back to reference Er F, Michels G, Brandt MC, Khan I, Haase H, Eicks M, Lindner M, Hoppe UC (2007) Impact of testosterone on cardiac L-type calcium channels and Ca2+ sparks: acute actions antagonize chronic effects. Cell Calcium 41:467–477CrossRefPubMed Er F, Michels G, Brandt MC, Khan I, Haase H, Eicks M, Lindner M, Hoppe UC (2007) Impact of testosterone on cardiac L-type calcium channels and Ca2+ sparks: acute actions antagonize chronic effects. Cell Calcium 41:467–477CrossRefPubMed
27.
go back to reference Golden KL, Marsh JD, Jiang Y, Brown T, Moulden J (2003) Gonadectomy of adult male rats reduces contractility of isolated cardiac myocytes. Am J Physiol Endocrinol Metab 285:449–453CrossRef Golden KL, Marsh JD, Jiang Y, Brown T, Moulden J (2003) Gonadectomy of adult male rats reduces contractility of isolated cardiac myocytes. Am J Physiol Endocrinol Metab 285:449–453CrossRef
28.
go back to reference Heiss R, Wiesmueller M, Treutlein C, Seuss H, Uder M, May M, Wuest W (2018) Cardiac T2 star mapping: standardized inline analysis of long and short axis at three identical 1.5 T MRI scanners. Int J Cardiovasc Imaging 21:1–8 Heiss R, Wiesmueller M, Treutlein C, Seuss H, Uder M, May M, Wuest W (2018) Cardiac T2 star mapping: standardized inline analysis of long and short axis at three identical 1.5 T MRI scanners. Int J Cardiovasc Imaging 21:1–8
Metadata
Title
Androgen-deprivation therapy impairs left ventricle functions in prostate cancer patients
Authors
Batur Gonenc Kanar
Beste Ozben
Murat Sunbul
Emre Şener
Onur Ozkan
Ilker Tınay
Mustafa Kursat Tigen
Publication date
01-07-2019
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 7/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-019-02184-4

Other articles of this Issue 7/2019

International Urology and Nephrology 7/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.