Whether exercises and testosterone replacement therapy support a treatment for cardiovascular and atherosclerotic patients with iliac artery stenosis and low total testosterone and high-density lipoprotein cholesterol after endovascular procedure?

Authors

DOI:

https://doi.org/10.14739/2310-1210.2023.2.268513

Keywords:

exercise, testosterone replacement therapy, critical iliac stenosis II A and B, serum testosterone

Abstract

Serum levels of testosterone (ST) and high-density lipoprotein (HDL) are generally associated with atherosclerosis in male patients over 50 years with critic iliac stenosis (TASC II A and B) and cardiovascular disease with significant changes in HDL and low-density lipoprotein (LDL). In addition to the standard therapy, combined medicamentous therapy and adequate model of exercise are also important factors as medicines can improve HDL levels and primary bypass and endovascular potency impacting positively on improvement of ST or it can be the following testosterone replacement therapy (TRT) comprising cardiovascular disease prevention and vascular treatment as adjunct therapy options after endovascular and vascular surgical procedures.

The aim of the study is to identify the association between HDL and ST after surgical and endovascular intervention on the iliac segment (TASCII A and B), as well as cardiovascular risk factors with modified medium activity (MET) <6 with short interval increase over >6 (MET), with total duration of 30–60 minutes. It also attempts to remodel a patient behavioral pattern, optimize ST levels and link them to outcomes and patency of vascular procedures on the iliac segment.

Materials and methods. 108 selected male patients with cardiovascular disease combined with metabolic syndrome and critical iliac artery stenosis (TASC II A and B) were examined during 2014–2018, 4 years after invasive and minimal invasive treatment (54 patients were treated with surgical Dacron reconstruction and 54 patients – with endovascular treatment on short segment of critical iliac artery stenosis (TASC II A and B).

Results. In the total population, no difference was observed in changes of constraint-induced movement therapy between the standard exercise group and the control one after 4 years from baseline. However, there was no significant interaction between the effect of exercise trainings and primary bypass potency within 4 years.

Conclusions. Primary effects of endovascular procedure and Dacron bypass revascularization raise the risk of elevated testosterone levels after 4 years of group training but does not provide adequate answers to questions as to whether higher levels of ST have any major influence on primary bypass potency preventing further progression of cardiovascular disease and general symptomatic and asymptomatic atherosclerosis. However, exercise and TRT can be potential adjunctive therapeutic options for a future supporting postsurgical and endovascular illiac treatment in cardiovascular patients with low testosterone levels.

Author Biographies

Sid Solaković, Department for Vascular Surgery, Special Hospital Dr. Solakovic, Sarajevo, Bosnia and Herzegovina

MD, PhD, DSc, Associate Professor, Medical Faculty of International University of Gorazde

Nina Solaković, Dermatology Department, Special Hospital Dr. Solakovic, Bosnia and Herzegovina

MD

Anes Jogunčić, Sarajevo School of Science and Technology, Bosnia and Herzegovina

MD, PhD, DSc, Senior Lecturer

Hajrudin Spahović, Sarajevo School of Science and Technology, Bosnia and Herzegovina

MD, PhD, DSc, Associate Professor, Medical School

Fedja Hajrulahović, Health Center, Sarajevo, Bosnia and Herzegovina

MD, PhD, DSc, Specialist in Internal Medicine

Ratko Pavlović, University of East Sarajevo, Bosnia and Herzegovina

MD, PhD, Professor, Faculty of Physical Education and Sport

Mensur Vrcić , University of Sarajevo, Bosnia and Herzegovina

Professor, Faculty of Sport and Physical Education

Emir Solaković, Special Hospital Dr. Solakovic, Sarajevo, Bosnia and Herzegovina

MD, PhD, DSc, Professor

Amina Godinjak, Cardiovascular Surgery Clinic and Vascular Surgery Department, Clinical Center of the University in Sarajevo, Bosnia and Herzegovina

MD, PhD, DSc

Iryna Skrypchenko, Dnipropetrovsk State University of Internal Affairs, Dnipro, Ukraine

Associate Professor, Department of Physical Education and Tactical & Special Training

Olena Dorofieieva, Bogomolets National Medical University, Kyiv, Ukraine

MD, PhD, DSc, Professor, Department of Physical Rehabilitation and Sport Medicine

Kseniia Yarymbash, Bogomolets National Medical University, Kyiv, Ukraine

PhD, Associate Professor, Department of Physical Rehabilitation and Sport Medicine

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2023-03-28

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Solaković S, Solaković N, Jogunčić A, Spahović H, Hajrulahović F, Pavlović R, Vrcić M, Solaković E, Godinjak A, Skrypchenko I, Dorofieieva O, Yarymbash K. Whether exercises and testosterone replacement therapy support a treatment for cardiovascular and atherosclerotic patients with iliac artery stenosis and low total testosterone and high-density lipoprotein cholesterol after endovascular procedure?. Zaporozhye Medical Journal [Internet]. 2023Mar.28 [cited 2024Jul.20];25(2):101-8. Available from: http://zmj.zsmu.edu.ua/article/view/268513