Purpose: Arterial-ventricular coupling (EA/ELV) constitutes an important determinant of cardiovascular performance and cardiac energetic. There is increasing evidence of testosterone influence to cardiovascular health. Aim of this work is to investigate the impact of testosterone deficiency (TD) on arterial-ventricular coupling, documented by the accuracy of the three dimensional echocardiography.

Methods: 76 men (56±11 years) underwent cardiac ultrasound and carotid-femoral pulse wave velocity (PWVc-f) evaluation. Based on systolic blood pressure (SBP), end systolic blood pressure was defined (ESP=0,9XSBP) and 3D- echo evaluation of ejection fraction (EF) and left ventricular outflow tract area (CSALVOT) were performed. Consequently left ventricular stroke volume (SV=VTI x CSA), end-diastolic (EDV) and end-systolic (ESV) volumes were estimated, followed by LV elastance (ELV=ESP/ESV-V0), arterial elastance (EA=ESP/SV) and arterial-ventricular coupling (EA/ELV) calculation. Testosterone deficiency considered when the total testosterone (TT) < 3.4 ng/m.

Results: Compared to normal TT levels, TD patients (n=19) were older (59± 8vs 52±10 years, P<0.05) with higher BMI (28.6± 4.0 kg/m² vs 27.0±4 kg/m², P<0.05). They had lower EF, SV and inversely, higher EA/ELV compared to subjects with normal TT. TD was also associated to a higher mitral E/E’ and PWVc-f. The association remained significant in multivariate analysis after adjustment for age and cardiovascular risk factors.

Conclusion: Testosterone deficiency associates to an unfavorable LV performance as well to central arterial stiffness, with an adverse outcome on cardiac energetic. This information adds clinical value on hormone lower level, in both cardiovascular risk assessment and stratification of future preventive strategies.