{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T10:21:54Z","timestamp":1769077314088,"version":"3.49.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":4158,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2014,9,30]],"date-time":"2014-09-30T00:00:00Z","timestamp":1412035200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Male ageing is characterized by diminished circulating androgens with several adverse psychosomatic consequences and can be aggravated by concomitant chronic diseases. According to the European Male Aging Study (EMAS) Group, late-onset hypogonadism (LOH) refers to testosterone deficiency accompanied by sexual complaints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We investigated the prevalence of LOH in men with systolic heart failure (HF), and its clinical determinants and prognostic consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 201 men with systolic HF (age: 60 \u00b1 11 years), serum total testosterone (TT) was assessed using an immunoassay, and estimated free testosterone (eFT) was calculated using Vermeulen's formula. LOH was diagnosed when TT &amp;lt; 3.2 ng\/mL and eFT &amp;lt; 64 pg\/mL were accompanied by three sexual symptoms (decrease in the number of morning erections, reduced potency, and low libido) of at least moderate severity assessed using the Aging Males' Symptoms Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Decreased frequency of morning erections, reduced potency, and low libido were experienced by 56%, 62%, and 55% of men with HF, respectively; whereas 67%, 61%, and 44% of subjects complained of at least one, two, and three symptoms, respectively. Hypogonadal TT and eFT were observed in 34% and 47% of patients, respectively; and in 33% subjects, both TT and eFT were reduced. Finally, 30 men with HF (15%) were diagnosed with LOH as compared with 2% in a European male population (EMAS). In a multivariable model, older age and higher serum uric acid were independently associated with greater LOH prevalence (both P &amp;lt; 0.05). Among men aged \u226460 years (but not in those aged &amp;gt;60 years), LOH increased 5-year all-cause mortality in the univariable model; however, when adjusted for HF severity, the association lost its statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Men with systolic HF commonly report sexual complaints. LOH\u2014the combination of sexual dysfunction and testosterone deficiency\u2014occurs more frequently than in a general male population. LOH does not affect long-term mortality, when adjusted for HF severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12002","type":"journal-article","created":{"date-parts":[[2014,9,30]],"date-time":"2014-09-30T15:34:46Z","timestamp":1412091286000},"page":"41-51","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Late-Onset Hypogonadism in Men with Systolic Heart Failure: Prevalence, Clinical Associates, and Impact on Long-Term Survival"],"prefix":"10.1093","volume":"1","author":[{"given":"Ewa A.","family":"Jankowska","sequence":"first","affiliation":[{"name":"Department of Heart Diseases, Wroc\u0142aw Medical University , Wroc\u0142aw ,","place":["Poland"]},{"name":"Cardiology Department, Centre for Heart Diseases, Military Hospital , Wroc\u0142aw ,","place":["Poland"]},{"name":"Institute of Anthropology, Polish Academy of Sciences , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Tkaczyszyn","sequence":"additional","affiliation":[{"name":"Department of Heart Diseases, Wroc\u0142aw Medical University , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinga","family":"W\u0119grzynowska-Teodorczyk","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centre for Heart Diseases, Military Hospital , Wroc\u0142aw ,","place":["Poland"]},{"name":"Faculty of Physiotherapy, University School of Physical Education , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Majda","sequence":"additional","affiliation":[{"name":"Laboratory Division, Military Hospital , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"von Haehling","sequence":"additional","affiliation":[{"name":"Division of Applied Cachexia Research, Department of Cardiology, Charit\u00e9 Medical School , Berlin ,","place":["Germany"]},{"name":"Department of Innovative Clinical Trials, University Medical Centre G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfram","family":"Doehner","sequence":"additional","affiliation":[{"name":"Division of Applied Cachexia Research, Department of Cardiology, Charit\u00e9 Medical School , Berlin ,","place":["Germany"]},{"name":"Centre for Stroke Research Berlin, Charit\u00e9 Medical School , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waldemar","family":"Banasiak","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centre for Heart Diseases, Military Hospital , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Division of Applied Cachexia Research, Department of Cardiology, Charit\u00e9 Medical School , Berlin ,","place":["Germany"]},{"name":"Department of Innovative Clinical Trials, University Medical Centre G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Department of Heart Diseases, Wroc\u0142aw Medical University , Wroc\u0142aw ,","place":["Poland"]},{"name":"Cardiology Department, Centre for Heart Diseases, Military Hospital , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2014,9,30]]},"reference":[{"issue":"2","key":"2026012113023328800_ehf212002-bib-0001","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1210\/jcem.86.2.7219","article-title":"Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging","volume":"86","author":"Harman","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0002","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1210\/jcem.87.2.8201","article-title":"Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study","volume":"87","author":"Feldman","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0003","doi-asserted-by":"crossref","first-page":"M76","DOI":"10.1093\/gerona\/57.2.M76","article-title":"Andropause: clinical implications of the decline in serum testosterone levels with aging in men","volume":"57","author":"Matsumoto","year":"2002","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0004","doi-asserted-by":"publisher","first-page":"192","DOI":"10.4103\/1008-682X.122336","article-title":"Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment","volume":"16","author":"Huhtaniemi","year":"2014","journal-title":"Asian J Androl"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0005","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1038\/aja.2011.138","article-title":"How to recognize late-onset hypogonadism in men with sexual dysfunction","volume":"14","author":"Corona","year":"2012","journal-title":"Asian J Androl."},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0006","doi-asserted-by":"crossref","first-page":"M88","DOI":"10.1093\/gerona\/56.2.M88","article-title":"Heart failure in the 21st century: a cardiogeriatric syndrome","volume":"56","author":"Rich","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"3","key":"2026012113023328800_ehf212002-bib-0007","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S1388-9842(00)00141-0","article-title":"More \u2018malignant\u2019 than cancer? Five-year survival following a first admission for heart failure","volume":"3","author":"Stewart","year":"2001","journal-title":"Eur J Heart Fail"},{"issue":"3","key":"2026012113023328800_ehf212002-bib-0008","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S1388-9842(01)00198-2","article-title":"The current cost of heart failure to the National Health Service in the UK","volume":"4","author":"Stewart","year":"2002","journal-title":"Eur J Heart Fail"},{"issue":"11","key":"2026012113023328800_ehf212002-bib-0009","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1056\/NEJMra063052","article-title":"The failing heart\u2014an engine out of fuel","volume":"356","author":"Neubauer","year":"2007  15","journal-title":"N Engl J Med"},{"issue":"3","key":"2026012113023328800_ehf212002-bib-0010","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1093\/cvr\/cvn301","article-title":"Energy metabolism in heart failure and remodelling","volume":"81","author":"Ingwall","year":"2009  15","journal-title":"Cardiovasc Res"},{"issue":"1","key":"2026012113023328800_ehf212002-bib-0011","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1242\/dmm.010389","article-title":"Cellular and molecular mechanisms of muscle atrophy","volume":"6","author":"Bonaldo","year":"2013","journal-title":"Dis Model Mech"},{"issue":"9058","key":"2026012113023328800_ehf212002-bib-0012","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/S0140-6736(96)07015-8","article-title":"Wasting as independent risk factor for mortality in chronic heart failure","volume":"349","author":"Anker","year":"1997  12","journal-title":"Lancet"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0013","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1161\/01.CIR.96.2.526","article-title":"Hormonal changes and catabolic\/anabolic imbalance in chronic heart failure and their importance for cardiac cachexia","volume":"96","author":"Anker","year":"1997  15","journal-title":"Circulation"},{"issue":"17","key":"2026012113023328800_ehf212002-bib-0014","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1161\/CIRCULATIONAHA.106.649426","article-title":"Anabolic deficiency in men with chronic heart failure: prevalence and detrimental impact on survival","volume":"114","author":"Jankowska","year":"2006  24","journal-title":"Circulation"},{"issue":"7","key":"2026012113023328800_ehf212002-bib-0015","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1136\/hrt.2009.181065","article-title":"Low circulating androgens and mortality risk in heart failure","volume":"96","author":"G\u00fcder","year":"2010","journal-title":"Heart"},{"issue":"5","key":"2026012113023328800_ehf212002-bib-0016","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1038\/aja.2011.26","article-title":"Testosterone level and mortality in elderly men with systolic chronic heart failure","volume":"13","author":"Wu","year":"2011","journal-title":"Asian J Androl"},{"issue":"3","key":"2026012113023328800_ehf212002-bib-0017","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3109\/13685538.2013.807427","article-title":"Anabolic deficiencies in men with systolic heart failure: do co-morbidities and therapies really contribute significantly?","volume":"16","author":"Kalici\u0144ska","year":"2013","journal-title":"Aging Male"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0018","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1056\/NEJMoa0911101","article-title":"Identification of late-onset hypogonadism in middle-aged and elderly men","volume":"363","author":"Wu","year":"2010","journal-title":"N Engl J Med"},{"issue":"10","key":"2026012113023328800_ehf212002-bib-0019","doi-asserted-by":"crossref","first-page":"3666","DOI":"10.1210\/jcem.84.10.6079","article-title":"A critical evaluation of simple methods for the estimation of free testosterone in serum","volume":"84","author":"Vermeulen","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026012113023328800_ehf212002-bib-0020","first-page":"461","article-title":"A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation","volume":"130","author":"Levey","year":"1999  16","journal-title":"Modification of Diet in Renal Disease Study Group. Ann Intern Med."},{"key":"2026012113023328800_ehf212002-bib-0021","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3109\/13685539909003173","article-title":"A new \u2018aging males\u2019 symptoms' rating scale","volume":"2","author":"Heinemann","year":"1999","journal-title":"The Aging Male."},{"key":"2026012113023328800_ehf212002-bib-0022","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/1477-7525-1-77","article-title":"The Aging Males' Symptoms (AMS) scale: review of its methodological characteristics","volume":"1","author":"Daig","year":"2003  15","journal-title":"Health Qual Life Outcomes"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0023","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/13685530701778020","article-title":"Age and social gradients in the intensity of aging males' symptoms in Poland","volume":"11","author":"Jankowska","year":"2008","journal-title":"Aging Male"},{"issue":"4","key":"2026012113023328800_ehf212002-bib-0024","doi-asserted-by":"crossref","first-page":"156","DOI":"10.20452\/pamw.1680","article-title":"Andropausal syndrome in men with systolic heart failure","volume":"123","author":"Tkaczyszyn","year":"2013","journal-title":"Pol Arch Med Wewn"},{"issue":"10","key":"2026012113023328800_ehf212002-bib-0025","doi-asserted-by":"publisher","first-page":"2795","DOI":"10.1111\/j.1743-6109.2009.01416.x","article-title":"Erectile dysfunction in heart failure: correlation with severity, exercise performance, comorbidities, and heart failure treatment","volume":"6","author":"Apostolo","year":"2009","journal-title":"J Sex Med"},{"issue":"1","key":"2026012113023328800_ehf212002-bib-0026","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S1474-5151(01)00009-3","article-title":"Sexual problems in heart failure patients","volume":"1","author":"Jaarsma","year":"2002","journal-title":"Eur J Cardiovasc Nurs"},{"issue":"1","key":"2026012113023328800_ehf212002-bib-0027","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/sj.ijir.3901613","article-title":"The prevalence and clinical relevance of sexual dysfunction in women and men with chronic heart failure","volume":"20","author":"Schwarz","year":"2008 -","journal-title":"Int J Impot Res"},{"issue":"4","key":"2026012113023328800_ehf212002-bib-0028","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/S0147-9563(96)80061-6","article-title":"Sexual function in patients with advanced heart failure","volume":"25","author":"Jaarsma","year":"1996 -","journal-title":"Heart Lung"},{"issue":"6","key":"2026012113023328800_ehf212002-bib-0029","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.jacc.2006.05.052","article-title":"Erectile dysfunction in heart failure patients","volume":"48","author":"Schwarz","year":"2006  19","journal-title":"J Am Coll Cardiol"},{"issue":"22","key":"2026012113023328800_ehf212002-bib-0030","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1136\/heartjnl-2012-302305","article-title":"Sexual problems in elderly male and female patients with heart failure","volume":"98","author":"Hoekstra","year":"2012","journal-title":"Heart"},{"issue":"3","key":"2026012113023328800_ehf212002-bib-0031","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1007\/s11897-014-0202-z","article-title":"Sexual dysfunction in heart failure patients","volume":"11","author":"Jaarsma","year":"2014","journal-title":"Curr Heart Fail Rep"},{"issue":"5","key":"2026012113023328800_ehf212002-bib-0032","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1093\/eurjhf\/hfp042","article-title":"Oxidative stress and hyperuricaemia: pathophysiology, clinical relevance, and therapeutic implications in chronic heart failure","volume":"11","author":"Bergamini","year":"2009","journal-title":"Eur J Heart Fail"},{"issue":"5","key":"2026012113023328800_ehf212002-bib-0033","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1093\/oxfordjournals.eurheartj.a015352","article-title":"Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure","volume":"18","author":"Leyva","year":"1997","journal-title":"Eur Heart J"},{"issue":"12","key":"2026012113023328800_ehf212002-bib-0034","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1053\/euhj.1998.1188","article-title":"Uric acid in chronic heart failure: a marker of chronic inflammation","volume":"19","author":"Leyva","year":"1998","journal-title":"Eur Heart J"},{"issue":"17","key":"2026012113023328800_ehf212002-bib-0035","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1161\/CIRCULATIONAHA.106.649426","article-title":"Anabolic deficiency in men with chronic heart failure: prevalence and detrimental impact on survival","volume":"114","author":"Jankowska","year":"2006  24","journal-title":"Circulation"},{"issue":"2","key":"2026012113023328800_ehf212002-bib-0036","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1210\/jc.2004-1184","article-title":"Older men are as responsive as young men to the anabolic effects of graded doses of testosterone on the skeletal muscle","volume":"90","author":"Bhasin","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026012113023328800_ehf212002-bib-0037","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1210\/jc.2013-2052","article-title":"Late-onset hypogonadism and mortality in aging men","volume":"99","author":"Pye","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2026012113023328800_ehf212002-bib-0038","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1136\/hrt.2003.025270","article-title":"Clinical epidemiology of heart failure","volume":"93","author":"Mosterd","year":"2007","journal-title":"Heart"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fehf2.12002","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/1\/1\/41\/63970287\/eschf_1_1_41.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/1\/1\/41\/63970287\/eschf_1_1_41.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:02:40Z","timestamp":1769018560000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/1\/1\/41\/8214244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,1]]},"references-count":38,"aliases":["10.1002\/2055-5822.12002"],"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,9,30]]},"published-print":{"date-parts":[[2014,9,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.12002","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2014,9]]},"published":{"date-parts":[[2014,9,1]]},"assertion":[{"value":"2014-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}