Background. While anabolic hormone deficit is a common finding in heart failure with reduced ejection fraction (HFrEF), few data are available in heart failure with preserved ejection fraction (HFpEF). Methods. Blood samples were collected for metabolic (total cholesterol, HDL cholesterol, LDL cholesterol, creatinine, and glucose) and hormonal (IGF-1, DHEA-S, TSH, fT3, fT4, and T) determination, comparing 30 patients with HFpEF and 20 patients with HFrEF. Total antioxidant capacity was evaluated by using the spectrophotometric method using the latency time in the appearance of the radical species of a chromogen (LAG, sec) as a parameter proportional to antioxidant content of the sample. Echocardiographic parameters were also assessed in the two groups. Results. A high prevalence of testosterone (32% in HFrEF and 72% in HFpEF, p<0.05) and DHEA-S deficiencies was observed in HFpEF patients. Echocardiographic parameters did not correlate with hormone values. A significant direct correlation between T (r2 = 0.25, p<0.05) and DHEA-S (r2 = 0.19, p<0.05) with LAG was observed only in HFpEF. Conclusion. Anabolic hormone deficiency is clearly shown in HFpEF, as already known in HFrEF. Although longitudinal studies are required to confirm the prognostic value of this observation, our data suggest different mechanisms in modulating antioxidants in the two conditions, with possible therapeutic implications.

Post-dialysis fatigue and peri-dialytic serum lactate levels in patients on chronic hemodialysis Dear Editor Many patients, following a hemodialysis treatment, report to feel tired and the needing of a rest or sleeping time, a condition called post dialysis fatigue (PDF) [1]. Intradialytic hypotension may contribute to muscle ischemia, accumulation of lactate in the muscle, high serum lactate (SL) levels, muscle fatigue, and PDF [1]. This study aims to measure peri-dialytic SL concentrations in patients on hemodialysis with and without PDF. Exclusion criteria were dialysis duration <1 year, dementia based on DSM-IV criteria, infectious disease, active cancer, vascular access though a central venous catheter, heart or respiratory failure, hemorrhage, alcohol abuse, shock, and liver disease. Age, gender, underlying renal disease, BMI, hemodialysis regimen, Charlson comorbidity index were recorded. According to Sklar et al., patients were suffering from PDF if they offered this complaint when asked the open-ended question: "Do you feel fatigued after dialysis?" Each patient was Note: Spearman's rho and significance values are reported ( p). Abbreviations: PDF, post-dialysis fatigue; TIRD, time of recovery after hemodialysis.

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