Multiple hormonal and metabolic deficiency syndrome in chronic heart failure

TOSCA Investigators, E Bossone, M Arcopinto, M Iacoviello, V Triggiani, F Cacciatore, C Maiello, G Limongelli, D Masarone, F Perticone, A Sciacqua, P Perrone-Filardi, A Mancini, M Volterrani, O Vriz, R Castello, A Passantino, M Campo, P A Modesti, A De GiorgiI Monte, A Puzzo, A Ballotta, L Caliendo, R D'Assante, A M Marra, A Salzano, T Suzuki, A Cittadini

Research output: Contribution to journalArticle

Abstract

Recent evidence supports the concept that progression of chronic heart failure (CHF) depends upon an imbalance of catabolic forces over the anabolic drive. In this regard, multiple hormonal deficiency syndrome (MHDS) significantly has impacts upon CHF progression, and is associated with a worse clinical status and increased mortality. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Therapy in Heart Failure) Registry (clinicaltrial.gov = NCT02335801) tests the hypothesis that anabolic deficiencies reduce survival in a large population of mild-to-moderate CHF patients. The T.O.S.CA. Registry is a prospective multicenter observational study coordinated by "Federico II" University of Naples, and involves 19 centers situated throughout Italy. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydroepiandrosterone , and insulin are measured at baseline and every year for a patient-average follow-up of 3 years. Subjects with CHF are divided into two groups: patients with one or no anabolic deficiency, and patients with two or more anabolic deficiencies at baseline. The primary endpoint is the composite of all-cause mortality and cardiovascular hospitalization. Secondary endpoints include the composite of all-cause mortality and hospitalization, the composite of cardiovascular mortality and cardiovascular hospitalization, and change of VO2 peak. Patient enrollment started in April 2013, and was completed in July 2017. Demographics and main clinical characteristics of enrolled patients are provided in this article. Detailed cross-sectional results will be available in late 2018. The T.O.S.CA. Registry represents the most robust prospective observational trial on MHDS in the field of CHF. The study findings will advance our knowledge with regard to the intimate mechanisms of CHF progression and hopefully pave the way for future randomized clinical trials of single or multiple hormonal replacement therapies in CHF.
Original languageEnglish
Pages (from-to)661-671
Number of pages11
JournalInternal and Emergency Medicine
Volume13
Issue number5
DOIs
Publication statusPublished - Aug 2018

Fingerprint

Heart Failure
Registries
Hospitalization
Mortality
Dehydroepiandrosterone
Somatomedins
Thyroid Hormones
Italy
Multicenter Studies
Observational Studies
Randomized Controlled Trials
Demography
Hormones
Insulin
Survival
Therapeutics
Population

Keywords

  • Aged
  • Biomarkers/metabolism
  • Chronic Disease
  • Deficiency Diseases/metabolism
  • Disease Progression
  • Female
  • Heart Failure/metabolism
  • Humans
  • Italy
  • Male
  • Metabolic Diseases/metabolism
  • Middle Aged
  • Prospective Studies
  • Registries

Cite this

Investigators, TOSCA., Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., ... Cittadini, A. (2018). Multiple hormonal and metabolic deficiency syndrome in chronic heart failure. Internal and Emergency Medicine, 13(5), 661-671. https://doi.org/10.1007/s11739-018-1844-8

Multiple hormonal and metabolic deficiency syndrome in chronic heart failure. / Investigators, TOSCA; Bossone, E; Arcopinto, M; Iacoviello, M; Triggiani, V; Cacciatore, F; Maiello, C; Limongelli, G; Masarone, D; Perticone, F; Sciacqua, A; Perrone-Filardi, P; Mancini, A; Volterrani, M; Vriz, O; Castello, R; Passantino, A; Campo, M; Modesti, P A; De Giorgi, A; Monte, I; Puzzo, A; Ballotta, A; Caliendo, L; D'Assante, R; Marra, A M; Salzano, A; Suzuki, T; Cittadini, A.

In: Internal and Emergency Medicine, Vol. 13, No. 5, 08.2018, p. 661-671.

Research output: Contribution to journalArticle

Investigators, TOSCA, Bossone, E, Arcopinto, M, Iacoviello, M, Triggiani, V, Cacciatore, F, Maiello, C, Limongelli, G, Masarone, D, Perticone, F, Sciacqua, A, Perrone-Filardi, P, Mancini, A, Volterrani, M, Vriz, O, Castello, R, Passantino, A, Campo, M, Modesti, PA, De Giorgi, A, Monte, I, Puzzo, A, Ballotta, A, Caliendo, L, D'Assante, R, Marra, AM, Salzano, A, Suzuki, T & Cittadini, A 2018, 'Multiple hormonal and metabolic deficiency syndrome in chronic heart failure', Internal and Emergency Medicine, vol. 13, no. 5, pp. 661-671. https://doi.org/10.1007/s11739-018-1844-8
Investigators TOSCA, Bossone E, Arcopinto M, Iacoviello M, Triggiani V, Cacciatore F et al. Multiple hormonal and metabolic deficiency syndrome in chronic heart failure. Internal and Emergency Medicine. 2018 Aug;13(5):661-671. https://doi.org/10.1007/s11739-018-1844-8
Investigators, TOSCA ; Bossone, E ; Arcopinto, M ; Iacoviello, M ; Triggiani, V ; Cacciatore, F ; Maiello, C ; Limongelli, G ; Masarone, D ; Perticone, F ; Sciacqua, A ; Perrone-Filardi, P ; Mancini, A ; Volterrani, M ; Vriz, O ; Castello, R ; Passantino, A ; Campo, M ; Modesti, P A ; De Giorgi, A ; Monte, I ; Puzzo, A ; Ballotta, A ; Caliendo, L ; D'Assante, R ; Marra, A M ; Salzano, A ; Suzuki, T ; Cittadini, A. / Multiple hormonal and metabolic deficiency syndrome in chronic heart failure. In: Internal and Emergency Medicine. 2018 ; Vol. 13, No. 5. pp. 661-671.
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AU - Investigators, TOSCA

AU - Bossone, E

AU - Arcopinto, M

AU - Iacoviello, M

AU - Triggiani, V

AU - Cacciatore, F

AU - Maiello, C

AU - Limongelli, G

AU - Masarone, D

AU - Perticone, F

AU - Sciacqua, A

AU - Perrone-Filardi, P

AU - Mancini, A

AU - Volterrani, M

AU - Vriz, O

AU - Castello, R

AU - Passantino, A

AU - Campo, M

AU - Modesti, P A

AU - De Giorgi, A

AU - Monte, I

AU - Puzzo, A

AU - Ballotta, A

AU - Caliendo, L

AU - D'Assante, R

AU - Marra, A M

AU - Salzano, A

AU - Suzuki, T

AU - Cittadini, A

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KW - Aged

KW - Biomarkers/metabolism

KW - Chronic Disease

KW - Deficiency Diseases/metabolism

KW - Disease Progression

KW - Female

KW - Heart Failure/metabolism

KW - Humans

KW - Italy

KW - Male

KW - Metabolic Diseases/metabolism

KW - Middle Aged

KW - Prospective Studies

KW - Registries

U2 - 10.1007/s11739-018-1844-8

DO - 10.1007/s11739-018-1844-8

M3 - Article

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SP - 661

EP - 671

JO - Internal and Emergency Medicine

JF - Internal and Emergency Medicine

SN - 1828-0447

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ER -