Growth Hormone Deficiency in Patients with Chronic Heart Failure and Beneficial Effects of Its Correction(604 views) Cittadini A, Saldamarco L, Marra AM, Arcopinto M, Carlomagno G, Imbriaco M, Del Forno D, Vigorito C, Merola B, Oliviero U, Fazio S, Sacca L
Keywords: Amino Terminal Pro Brain Natriuretic Peptide, Human Growth Hormone, Somatomedin C, Absence Of Side Effects, Adult, Article, Blood Vessel Reactivity, Cardiovascular Effect, Clinical Trial, Controlled Clinical Trial, Controlled Study, Disease Marker, Drug Dose Increase, Drug Dose Reduction, Drug Safety, Exercise, Female, Growth Hormone Deficiency, Heart Ejection Fraction, Heart Failure, Heart Left Ventricle Ejection Fraction, Hormone Substitution, Major Clinical Study, Oxygen Consumption, Physical Performance, Prevalence, Priority Journal, Quality Of Life, Randomized Controlled Trial, Single Blind Procedure, United States, Affect, Aged, Exercise Test, Hormone Replacement Therapy, Insulin-Like Growth Factor I, Middle Aged, Peptide Fragments, Single-Blind Method, Ventricular Function,
Affiliations: *** IBB - CNR ***
Department of Internal Medicine and Cardiovascular Sciences, University Federico II, 80131 Naples, Italy
Department of Radiology, University Federico II, 80131 Naples, Italy
Department of Molecular and Clinical Endocrinology and Oncology, University Federico II, 80131 Naples, Italy
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Ros n, T., Bengtsson, B. A., Premature mortality due to cardiovascular disease in hypopituitarism (1990) Lancet, 336, pp. 285-288
(2008) Agenzia Italiana del Farmaco Nota 39, , http: //www. guidausofarmaci. it/pag9822. htm, (Italian). October 6
Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., (1970) Manual for the State-trait Anxiety Inventory (Self-evaluation Questionnaire), pp. 33-37. , Palo Alto, CA: Consulting Psychologists Press
Zung, W. W. K., A self-rating depression scale (1965) Arch Gen Psychiatry, 12, pp. 63-70
Corretti, M. C., Anderson, T. J., Benjamin, E. J., Celermajer, D., Charbonneau, F., Creager, M. A., Deanfield, J., Vogel, R., Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: A report of the international brachial artery reactivity task force (2002) Journal of the American College of Cardiology, 39 (2), pp. 257-265. , DOI 10. 1016/S0735-1097 (01) 01746-6, PII S0735109701017466
Kontoleon, P. E., Anastasiou-Nana, M. I., Papapetrou, P. D., Alexopoulos, G., Ktenas, V., Rapti, A. C., Tsagalou, E. P., Nanas, J. N., Hormonal profile in patients with congestive heart failure (2003) International Journal of Cardiology, 87 (2-3), pp. 179-183. , DOI 10. 1016/S0167-5273 (02) 00212-7, PII S0167527302002127
Anker, S. D., Volterrani, M., Pflaum, C. -D., Strasburger, C. J., Osterziel, K. J., Doehner, W., Ranke, M. B., Coats, A. J. S., Acquired growth hormone resistance in patients with chronic heart failure: Implications for therapy with growth hormone (2001) Journal of the American College of Cardiology, 38 (2), pp. 443-452. , DOI 10. 1016/S0735-1097 (01) 01385-7, PII S0735109701013857
Mann, D. L., Bristow, M. R., Mechanisms and models in heart failure. The biochemical model and beyond (2005) Circulation, 111, pp. 2837-2849
Johansson, J. O., Larson, G., Andersson, M., Elmgren, A., Hynsj, L., Lindahl, A., Lundberg, P. A., Bengtsson, B. A., Treatment of growth hormone deficient adults with recombinant human growth hormone increases the concentration of growth hormone in the cerebrospinal fluidandaffects neurotransmitters (1995) Neuroendocrinology, 61, pp. 57-66
Suleiman, M. -S., Singh, R. J. R., Stewart, C. E. H., Apoptosis and the cardiac action of insulin-like growth factor I (2007) Pharmacology and Therapeutics, 114 (3), pp. 278-294. , DOI 10. 1016/j. pharmthera. 2007. 03. 001, PII S0163725807000496
Duerr, R. L., Huang, S., Miraliakbar, H. R., Clark, R., Chien, K. R., Ross Jr., J., Insulin-like growth factor-1 enhances ventricular hypertrophy and function during the onset of experimental heart failure (1995) J Clin Invest, 95, pp. 619-627
Osterziel, K. J., Strohm, O., Schuler, J., Friedrich, M., Hanlein, D., Willenbrock, R., Anker, S. D., Dietz, R., Randomised, double-blind, placebo-controlled trial of human recombinant growth hormone in patients with chronic heart failure due to dilated cardiomyopathy (1998) Lancet, 351 (9111), pp. 1233-1237. , DOI 10. 1016/S0140-6736 (97) 11329-0
Ho, K. K., GH Deficiency Consensus Workshop participants 2007 Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: A statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia (2007) Eur J Endocrinol, 157, pp. 695-700
Growth Hormone Deficiency in Patients with Chronic Heart Failure and Beneficial Effects of Its Correction
Context: A reduced activity of the GH/IGF-I axis in chronic heart failure (CHF) has been described by several independent groups and is associated with poor clinical status and outcome. Objective: The aim of the current study was to investigate the prevalence of GH deficiency in a patient population with CHF and evaluate the cardiovascular effects of GH replacement therapy. Design and Setting: The randomized, single-blind, controlled trial was conducted at the Federico II University. Participants: One hundred fifty-eight patients with CHF, New York Heart Association class II-IV, underwent a GH stimulation test. Sixty-three patients satisfied the criteria for GH deficiency, and 56 of them were enrolled in the trial. Intervention: The treated group (n = 28) received GH at a replacement dose of 0.012 mg/kg every second day (similar to 2.5 IU). Main Outcomes Measures: Changes in physical performance and various cardiovascular indexes were measured. Results: GH replacement therapy improved quality of life score (from 46 +/- 5 to 38 +/- 4; P < 0.01), increased peak oxygen uptake and exercise duration (from 12.9 +/-. 9 to 14.5 +/- 1 ml/kg . min and from 520 +/- 36 to 586 +/- 43 sec, respectively; P < 0.01), and flow-mediated vasodilation (from 8.8 +/- 1.3 to 12.7 +/- 1.2%; P < 0.01). GH increased left ventricular ejection fraction (from 34 +/- 2to36 +/- 2%; P < 0.01) and reduced circulating N-terminal pro-brain natriuretic peptide levels (from 3201 +/- 900 to 2177 +/- 720 pg/ml; P = 0.006). No significant changes from baseline were observed in controls. Conclusions: As many as 40% of patients with CHF are GH deficient. GH replacement therapy in these patients improves exercise capacity, vascular reactivity, left ventricular function, and indices of quality of life. (J Clin Endocrinol Metab 94: 3329-3336, 2009)
Growth Hormone Deficiency in Patients with Chronic Heart Failure and Beneficial Effects of Its Correction
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Growth Hormone Deficiency in Patients with Chronic Heart Failure and Beneficial Effects of Its Correction