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The growth hormone and insulin-like growth factor 1 axis in heart failure
1Division of Cardiology, University Hospital, rue Micheli-du-Crest 24, 1211Geneva 14, Switzerland. Patrice.Delafontaine@hcuge.ch.
Insights
Growth hormone and IGF-1 show promise for improving heart function in heart failure models. Further research is needed to confirm their therapeutic potential in patients with heart failure.
Area of Science:
- Cardiology
- Endocrinology
- Molecular Biology
Background:
- Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) demonstrate positive effects on myocardial function in animal models of heart failure.
- An abnormal GH-IGF-1 axis, characterized by relative GH resistance, is observed in heart failure.
- Cardiac cachexia, a significant negative predictor in heart failure, is associated with elevated angiotensin II levels.
Purpose of the Study:
- To investigate the potential beneficial effects of GH and IGF-1 on myocardial function in heart failure.
- To explore the interaction between the renin-angiotensin system and the GH-IGF-1 axis in the context of heart failure and cachexia.
Main Methods:
- Review of experimental data on GH and IGF-1 in animal models of heart failure.
- Analysis of preliminary evidence regarding the GH-IGF-1 axis in heart failure patients.
- Examination of the relationship between angiotensin II, cachexia, and IGF-1 in cardiac and skeletal muscle.
Main Results:
- GH and IGF-1 exert beneficial effects including vasodilation, cardiac hypertrophy stimulation, enhanced myofilament calcium sensitivity, and apoptosis prevention.
- Angiotensin II infusion in rats induces weight loss via catabolism and increased protein degradation.
- Angiotensin II modulates IGF-1 levels, decreasing them in circulation and skeletal muscle while increasing them in cardiac muscle, along with IGF-1 receptor expression.
Conclusions:
- Preliminary data suggest a potential therapeutic role for GH in managing heart failure.
- Further clinical trials are essential to validate the efficacy of GH and/or IGF-1 as treatments for heart failure.
Abstract:
Experimental data suggests that growth hormone and IGF-1 have beneficial effects on myocardial function in animal models of heart failure. Preliminary evidence suggests an abnormality in the growth hormone-IGF-1 axis in heart failure with relative growth hormone resistance. Beneficial effects of growth hormone and IGF-1 include vasodilatation, stimulation of cardiac hypertrophy, increase in calcium sensitivity of cardiac myofilaments and prevention of apoptosis. Recently, cardiac cachexia has been shown to be a powerful negative predictive factor in heart failure. Cachectic patients have higher angiotensin II levels. In the rat there is an important interaction between the renin-angiotensin system and IGF-1. Thus, angiotensin II infusion causes weight loss in part through a catabolic effect. This effect results from increased protein degradation. Angiotensin II reduces circulating and skeletal muscle IGF-1 but increases IGF-1 and the IGF-IR expression in cardiac muscle. Preliminary data suggest a potential beneficial effect of growth hormone in heart failure. Further trials are necessary to test the potential beneficial effect of growth hormone and/or IGF-1 in heart failure.