Correlation of DHEA as a Precursor for Androgens and Estrogens with Echocardiographic Function and Dimensions of the Heart

Objectives: Dehydroepiandrosterone (DHEA) is a naturally occurring cholesterol-derived steroid hormone and serves in humans as a precursor for estrogens and androgens. DHEA has been solidly linked with beneficial effects in severe pulmonary hypertension and protective antioxidant effects for the right ventricle. Overall DHEA plays a central role for all these cardioprotective effects. We therefore aimed to examine the serum concentration of DHEA, DHEAS and sex hormones and correlated the results with left ventricular ejection fraction (LVEF) and echocardiographic dimension of the left and right ventricles and atria of 357 elective CABG patients in a period from 08/2016 to 06/2020 stratified by gender.

Methods: From 08/2016 to 06/2020, a total of 357 patients (302 males, 55 females) scheduled for elective coronary artery bypass surgery were evaluated. Mean age was 71.57 ± 6.34 years in females and 72.13 ± 6.67 years in males. LVEF was 51.56 ± 14.0% in females and 52.84 ± 4.45% in males. Sex hormone measurements for dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione, progesterone, estradiol, testosterone, dihydrotestosterone (DHT), and 11-deoxycortisol were measured with mass spectrometry from preoperative blood samples. We furthermore collected echocardiographic data and performed Pearson's correlation analyses as well as regression analyses.

Result: Among men, a significant positive correlation was found between DHEAS and age (p = 0.001), testosterone and LVEF (p = 0.001), DHT and LVEF (p = 0.003), and estradiol and RA size (p = 0.03). We found a significant negative correlation of DHEAS and RA size (p = 0.001) and DHEA and RA size (p = 0.001).

Among females, we found a significant positive correlation of 11-deoxycortisol and LVEF (p = 0.04) and significant negative correlation of androstenedione and age (p = 0.02) and progesterone and age (p = 0.04). We found no correlation of the ventricle sizes and left atrial size with anabolic hormones.

Conclusion: DHEA and its metabolite DHEAS seem to correlate significant with smaller right atrial sizes, higher left ventricular ejection fractions and older age in male patients undergoing elective CABG. If these findings might be predictors for longevity or contribute to healthy aging merits investigations. However this effect was not visible in females but might be caused by the age-related decline of DHEA in females from the age of 70 years and might contribute to higher cardiovascular risk in postmenopausal females.

Publication History

Article published online:
19 February 2021