Could gonadal and adrenal androgen deficiencies contribute to the depressive symptoms in men with systolic heart failure?

Background: Testosterone (TT) and dehydroepiandrosterone sulphate (DHEAS) are neurosteroids and their deficiencies constitute the hormone risk factors promoting the development of depression in elderly otherwise healthy men. We investigated the link between hypogonadism and depression in accordance with age and concomitant diseases in men with systolic HF using the novel scale previously dedicated for elderly population.

Methods: We analysed the prevalence of depression and severity of depressive symptoms in population of 226 men with systolic HF (40–80 years) compared to 379 healthy peers. The severity of depression was assessed using the Polish long version of Geriatric Depression Scale (GDS).

Results: In men aged 40–59 years the severity of depressive symptoms was greater in NYHA classes III–IV compared to NYHA classes I–II and reference group. In men aged 60–80 years depressive symptoms were more severe in NYHA class III-IV compared to controls (all p?≤?0.001). In multivariate logistic regression model in men aged 40–59 years advanced NYHA class was associated with higher prevalence of mild depression (OR?=?2.14, 95%CI: 1.07–4.29) and chronic obstructive pulmonary disease (COPD) with higher prevalence of severe depression (OR?=?69.1, 95%CI: 2.11–2264.3). In men aged 60–80 years advanced NYHA class and TT deficiency were related to higher prevalence of mild depression (respectively: OR?=?2.9, 95%CI: 1.3–6.4; OR?=?3.6, 95%CI: 1.2–10.63).

Conclusion: TT deficiency, COPD and advanced NYHA class were associated with higher prevalence of depression in men with systolic HF.