European Journal of Preventive Cardiology

, volume 28 , issue 15 , pages 1691-1700

Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry

Antonio Cittadini ^{1, 2}

Andrea Salzano ³

Massimo Iacoviello ⁴

Vincenzo Triggiani ⁵

Giuseppe Rengo ^{1, 6}

Francesco Cacciatore ¹

Ciro Maiello ⁷

Giuseppe Limongelli ⁸

Daniele Masarone ⁸

Francesco Perticone ⁹

Antonio Cimellaro ⁹

Pasquale Perrone-Filardi ^{10, 11}

Stefania Paolillo ^{10, 11}

Antonio Mancini ¹²

Maurizio Volterrani ¹³

Olga Vriz ¹⁴

Roberto Castello ¹⁵

Andrea Passantino ¹⁶

Michela Campo ¹⁷

Pietro A Modesti ¹⁸

Alfredo De Giorgi ¹⁹

Ines P Monte ²⁰

Alfonso Puzzo ²¹

Andrea Ballotta ²²

Roberta Dassante ^{1, 2}

Michele Arcopinto ^{1, 2}

Paola Gargiulo ¹⁰

Angela Sciacqua ⁹

Dario Bruzzese ²³

Annamaria Colao ²⁴

Raffaele Napoli ¹

Toru Suzuki ²⁵

Kim A. Eagle ²⁶

Hector O Ventura ²⁷

Alberto M. Marra ^{1, 2, 28}

Eduardo Bossone ^{2, 29}

Hide authors affiliations Show authors affiliations: 29 affiliations

Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy |

Italian Clinical Outcome Research and Reporting Program (I-CORRP), Naples, Italy |

IRCCS SDN, Diagnostic and Nuclear Research Institute, Naples, Italy |

⁴

Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy |

⁵

Interdisciplinary Department of Medicine, Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari ‘A Moro’, Bari, Italy |

⁶

Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB), IRCCS, Scientific Institute of Telese Terme, Telese BN, Italy |

⁷

Heart Transplantation Unit, Monaldi Hospital, Azienda Ospedaliera Dei Colli, Naples, Italy |

⁸

Division of Cardiology, Monaldi Hospital, Azienda Ospedaliera Dei Colli, University of Campania Luigi Vanvitelli, Caserta, Italy |

⁹

Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy |

¹⁰

Department of Advanced Biomedical Sciences, Federico Ii University, Naples, Italy |

¹¹

Mediterranea Cardiocentro, Naples, Italy |

¹²

Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy |

¹³

Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy |

¹⁴

Heart Center Department, King Faisal Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia |

¹⁵

Division of General Medicine, Azienda Ospedaliera Universitaria Integrata, Verona, Italy |

¹⁶

Scientific Clinical Institutes Maugeri, IRCCS, Pavia, Italy |

¹⁷

Department of Medical and Surgical Sciences, Unit of Endocrinology and Metabolic Diseases, University of Foggia, Foggia, Italy |

¹⁸

Dipartimento di Medicina Sperimentale e Clinica, Università degli studi di Firenze, Florence, Italy |

¹⁹

Department of Medical Sciences, School of Medicine, Pharmacy and Prevention, University of Ferrara, Ferrara, Italy |

²⁰

Department of General Surgery and Medical-Surgery Specialties, University of Catania, Catania, Italy |

²¹

IRCSS Oasi Maria SS, Troina, Enna, Italy |

²²

IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy |

²³

Department of Public Health, Federico II University, Naples, Italy |

²⁴

Clinical Medicine and Surgery Department, Federico II University, Naples, Italy |

²⁵

Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Glenfield Hospital, Leicester, UK |

²⁶

Michigan Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA |

²⁷

John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA |

²⁸

Center for Pulmonary Hypertension, Thoraxclinic at Heidelberg University Hospital, Heidelberg, Germany |

²⁹

Cardiology Division, A Cardarelli Hospital, Naples, Italy |

Publication type: Journal Article

Publication date: 2021-03-07

SAGE

European Journal of Preventive Cardiology

scimago Q1

wos Q1

SJR: 2.119

CiteScore: 13.9

Impact factor: 7.5

ISSN: 20474873, 20474881

DOI: 10.1093/eurjpc/zwab020

Copy DOI

PubMed ID: 33693736

Cardiology and Cardiovascular Medicine

Epidemiology

Abstract

Aims

Recent evidence supports the occurrence of multiple hormonal and metabolic deficiency syndrome (MHDS) in chronic heart failure (CHF). However, no large observational study has unequivocally demonstrated its impact on CHF progression and outcome. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Treatment in Heart Failure) Registry has been specifically designed to test the hypothesis that MHDS affects morbidity and mortality in CHF patients.

Methods and Results

The T.O.S.CA. Registry is a prospective, multicentre, observational study involving 19 Italian centres. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydropianoandrosterone sulfate, insulin resistance, and the presence of diabetes were evaluated. A MHDS was defined as the presence of ≥2 hormone deficiencies (HDs). Primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Four hundred and eighty heart failure patients with ejection fraction ≤45% were enrolled. MHDS or diabetes was diagnosed in 372 patients (77.5%). A total of 271 events (97 deaths and 174 cardiovascular hospitalizations) were recorded, 41% in NO-MHDS and 62% in MHDS (P < 0.001). Median follow-up was of 36 months. MHDS was independently associated with the occurrence of the primary endpoint [hazard ratio 95% (confidence interval), 1.93 (1.37–2.73), P < 0.001] and identified a group of patients with a higher mortality [2.2 (1.28–3.83), P = 0.01], with a graded relation between HDs and cumulative events (P < 0.01).

Conclusion

MHDS is common in CHF and independently associated with increased all-cause mortality and cardiovascular hospitalization, representing a promising therapeutic target.

Trial registration

ClinicalTrials.gov identifier: NCT023358017

Found

Top-30

Journals

	1 2 3 4
European Journal of Internal Medicine	European Journal of Internal Medicine, 4, 8.51% European Journal of Internal Medicine 4 publications, 8.51%
European Journal of Preventive Cardiology	European Journal of Preventive Cardiology, 4, 8.51% European Journal of Preventive Cardiology 4 publications, 8.51%
Endocrine, Metabolic and Immune Disorders - Drug Targets	Endocrine, Metabolic and Immune Disorders - Drug Targets, 3, 6.38% Endocrine, Metabolic and Immune Disorders - Drug Targets 3 publications, 6.38%
Heart Failure Clinics	Heart Failure Clinics, 3, 6.38% Heart Failure Clinics 3 publications, 6.38%
Internal and Emergency Medicine	Internal and Emergency Medicine, 2, 4.26% Internal and Emergency Medicine 2 publications, 4.26%
ESC heart failure	ESC heart failure, 2, 4.26% ESC heart failure 2 publications, 4.26%
Hormones	Hormones, 2, 4.26% Hormones 2 publications, 4.26%
Diagnostics	Diagnostics, 2, 4.26% Diagnostics 2 publications, 4.26%
Journal of Clinical Endocrinology and Metabolism	Journal of Clinical Endocrinology and Metabolism, 2, 4.26% Journal of Clinical Endocrinology and Metabolism 2 publications, 4.26%
JACC: Heart Failure	JACC: Heart Failure, 2, 4.26% JACC: Heart Failure 2 publications, 4.26%
Monaldi Archives for Chest Disease	Monaldi Archives for Chest Disease, 1, 2.13% Monaldi Archives for Chest Disease 1 publication, 2.13%
Journal of Cardiovascular Development and Disease	Journal of Cardiovascular Development and Disease, 1, 2.13% Journal of Cardiovascular Development and Disease 1 publication, 2.13%
Frontiers in Endocrinology	Frontiers in Endocrinology, 1, 2.13% Frontiers in Endocrinology 1 publication, 2.13%
Endocrine	Endocrine, 1, 2.13% Endocrine 1 publication, 2.13%
Cardiovascular Diabetology	Cardiovascular Diabetology, 1, 2.13% Cardiovascular Diabetology 1 publication, 2.13%
Pituitary	Pituitary, 1, 2.13% Pituitary 1 publication, 2.13%
Cardiology Clinics	Cardiology Clinics, 1, 2.13% Cardiology Clinics 1 publication, 2.13%
Cardiovascular Research	Cardiovascular Research, 1, 2.13% Cardiovascular Research 1 publication, 2.13%
BMC Cardiovascular Disorders	BMC Cardiovascular Disorders, 1, 2.13% BMC Cardiovascular Disorders 1 publication, 2.13%
Endocrines	Endocrines, 1, 2.13% Endocrines 1 publication, 2.13%
Life	Life, 1, 2.13% Life 1 publication, 2.13%
European Journal of Heart Failure	European Journal of Heart Failure, 1, 2.13% European Journal of Heart Failure 1 publication, 2.13%
Antioxidants	Antioxidants, 1, 2.13% Antioxidants 1 publication, 2.13%
Frontiers in Cardiovascular Medicine	Frontiers in Cardiovascular Medicine, 1, 2.13% Frontiers in Cardiovascular Medicine 1 publication, 2.13%
Clinical Endocrinology	Clinical Endocrinology, 1, 2.13% Clinical Endocrinology 1 publication, 2.13%
Vestnik Aritmologii	Vestnik Aritmologii, 1, 2.13% Vestnik Aritmologii 1 publication, 2.13%
Biomolecules	Biomolecules, 1, 2.13% Biomolecules 1 publication, 2.13%
Heart Failure Reviews	Heart Failure Reviews, 1, 2.13% Heart Failure Reviews 1 publication, 2.13%
International Journal of Molecular Sciences	International Journal of Molecular Sciences, 1, 2.13% International Journal of Molecular Sciences 1 publication, 2.13%
	1 2 3 4

Publishers

	2 4 6 8 10 12
Elsevier	Elsevier, 11, 23.4% Elsevier 11 publications, 23.4%
Springer Nature	Springer Nature, 9, 19.15% Springer Nature 9 publications, 19.15%
MDPI	MDPI, 8, 17.02% MDPI 8 publications, 17.02%
Bentham Science Publishers Ltd.	Bentham Science Publishers Ltd., 3, 6.38% Bentham Science Publishers Ltd. 3 publications, 6.38%
SAGE	SAGE, 3, 6.38% SAGE 3 publications, 6.38%
Frontiers Media S.A.	Frontiers Media S.A., 2, 4.26% Frontiers Media S.A. 2 publications, 4.26%
The Heart Failure Association of the European Society of Cardiology	The Heart Failure Association of the European Society of Cardiology, 2, 4.26% The Heart Failure Association of the European Society of Cardiology 2 publications, 4.26%
Oxford University Press	Oxford University Press, 2, 4.26% Oxford University Press 2 publications, 4.26%
Wiley	Wiley, 2, 4.26% Wiley 2 publications, 4.26%
The Endocrine Society	The Endocrine Society, 2, 4.26% The Endocrine Society 2 publications, 4.26%
PAGEPress Publications	PAGEPress Publications, 1, 2.13% PAGEPress Publications 1 publication, 2.13%
Cold Spring Harbor Laboratory	Cold Spring Harbor Laboratory, 1, 2.13% Cold Spring Harbor Laboratory 1 publication, 2.13%
Institute of Cardio Technics - INCART	Institute of Cardio Technics - INCART, 1, 2.13% Institute of Cardio Technics - INCART 1 publication, 2.13%
	2 4 6 8 10 12

We do not take into account publications without a DOI.
Statistics recalculated weekly.

Are you a researcher?

Create a profile to get free access to personal recommendations for colleagues and new articles.

PDF

Metrics

Cite this

GOST |

Cite this

GOST Copy

Cittadini A. et al. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry // European Journal of Preventive Cardiology. 2021. Vol. 28. No. 15. pp. 1691-1700.

GOST all authors (up to 50) Copy

Cittadini A., Salzano A., Iacoviello M., Triggiani V., Rengo G., Cacciatore F., Maiello C., Limongelli G., Masarone D., Perticone F., Cimellaro A., Perrone-Filardi P., Paolillo S., Mancini A., Volterrani M., Vriz O., Castello R., Passantino A., Campo M., Modesti P. A., De Giorgi A., Monte I. P., Puzzo A., Ballotta A., Dassante R., Arcopinto M., Gargiulo P., Sciacqua A., Bruzzese D., Colao A., Napoli R., Suzuki T., Eagle K. A., Ventura H. O., Marra A. M., Bossone E. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry // European Journal of Preventive Cardiology. 2021. Vol. 28. No. 15. pp. 1691-1700.

RIS |

Cite this

RIS Copy

TY - JOUR

DO - 10.1093/eurjpc/zwab020

UR - https://doi.org/10.1093/eurjpc/zwab020

TI - Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry

T2 - European Journal of Preventive Cardiology

AU - Cittadini, Antonio

AU - Salzano, Andrea

AU - Iacoviello, Massimo

AU - Triggiani, Vincenzo

AU - Rengo, Giuseppe

AU - Cacciatore, Francesco

AU - Maiello, Ciro

AU - Limongelli, Giuseppe

AU - Masarone, Daniele

AU - Perticone, Francesco

AU - Cimellaro, Antonio

AU - Perrone-Filardi, Pasquale

AU - Paolillo, Stefania

AU - Mancini, Antonio

AU - Volterrani, Maurizio

AU - Vriz, Olga

AU - Castello, Roberto

AU - Passantino, Andrea

AU - Campo, Michela

AU - Modesti, Pietro A

AU - De Giorgi, Alfredo

AU - Monte, Ines P

AU - Puzzo, Alfonso

AU - Ballotta, Andrea

AU - Dassante, Roberta

AU - Arcopinto, Michele

AU - Gargiulo, Paola

AU - Sciacqua, Angela

AU - Bruzzese, Dario

AU - Colao, Annamaria

AU - Napoli, Raffaele

AU - Suzuki, Toru

AU - Eagle, Kim A.

AU - Ventura, Hector O

AU - Marra, Alberto M.

AU - Bossone, Eduardo

PY - 2021

DA - 2021/03/07

PB - SAGE

SP - 1691-1700

IS - 15

VL - 28

PMID - 33693736

SN - 2047-4873

SN - 2047-4881

ER -

BibTex |

Cite this

BibTex (up to 50 authors) Copy

@article{2021_Cittadini,

author = {Antonio Cittadini and Andrea Salzano and Massimo Iacoviello and Vincenzo Triggiani and Giuseppe Rengo and Francesco Cacciatore and Ciro Maiello and Giuseppe Limongelli and Daniele Masarone and Francesco Perticone and Antonio Cimellaro and Pasquale Perrone-Filardi and Stefania Paolillo and Antonio Mancini and Maurizio Volterrani and Olga Vriz and Roberto Castello and Andrea Passantino and Michela Campo and Pietro A Modesti and Alfredo De Giorgi and Ines P Monte and Alfonso Puzzo and Andrea Ballotta and Roberta Dassante and Michele Arcopinto and Paola Gargiulo and Angela Sciacqua and Dario Bruzzese and Annamaria Colao and Raffaele Napoli and Toru Suzuki and Kim A. Eagle and Hector O Ventura and Alberto M. Marra and Eduardo Bossone},

title = {Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry},

journal = {European Journal of Preventive Cardiology},

year = {2021},

volume = {28},

publisher = {SAGE},

month = {mar},

url = {https://doi.org/10.1093/eurjpc/zwab020},

number = {15},

pages = {1691--1700},

doi = {10.1093/eurjpc/zwab020}

}

MLA

Cite this

MLA Copy

Cittadini, Antonio, et al. “Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry.” European Journal of Preventive Cardiology, vol. 28, no. 15, Mar. 2021, pp. 1691-1700. https://doi.org/10.1093/eurjpc/zwab020.

Publisher

SAGE

Journal

European Journal of Preventive Cardiology

scimago Q1

wos Q1

SJR

2.119

CiteScore

13.9

Impact factor

7.5

ISSN

20474873 (Print)

20474881 (Electronic)