Document Detail


Growth hormone deficiency in patients with chronic heart failure and beneficial effects of its correction.
MedLine Citation:
PMID:  19584187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (approximately 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 x 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 +/- 2 to 36 +/- 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.
Authors:
Antonio Cittadini; Lavinia Saldamarco; Alberto Maria Marra; Michele Arcopinto; Guido Carlomagno; Massimo Imbriaco; Domenico Del Forno; Carlo Vigorito; Bartolomeo Merola; Ugo Oliviero; Serafino Fazio; Luigi Sacc??
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-07-07
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  94     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-07     Completed Date:  2009-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3329-36     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine and Cardiovascular Sciences, University Federico II, Via Pansini, 5, 80131 Naples, Italy. antonio.cittadini@unina.it
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MeSH Terms
Descriptor/Qualifier:
Affect
Aged
Exercise Test
Female
Heart Failure / metabolism*,  psychology
Hormone Replacement Therapy
Human Growth Hormone / blood,  deficiency*,  therapeutic use
Humans
Insulin-Like Growth Factor I / analysis
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Oxygen Consumption
Peptide Fragments / blood
Quality of Life
Single-Blind Method
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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