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The GH/IGF-1 axis in chronic heart failure

Michele Arcopinto1, Emanuele Bobbio, Eduardo Bossone

  • 1Department of Internal Medicine, Cardiovascular Sciences and Clinical Immunology, University Federico II, Naples, Italy.

Endocrine, Metabolic & Immune Disorders Drug Targets
|February 2, 2013
PubMed

Insights

Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels are often low in Chronic Heart Failure (CHF). GH therapy shows mixed results, possibly due to varying impairment levels in patients.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Research

Background:

  • Chronic Heart Failure (CHF) is traditionally linked to neurohormonal overactivity.
  • Emerging evidence suggests hormone down-regulation, including the Growth Hormone (GH)/Insulin-like Growth Factor-1 (IGF-1) axis, in CHF patients.
  • The GH/IGF-1 axis is crucial for cardiac growth, contractility, and vascular function.

Purpose of the Study:

  • To discuss the biological actions of GH and IGF-1.
  • To explore the cardiovascular implications of GH deficiency and excess.
  • To examine the relationship between the somatotrophic axis and CHF, including therapeutic strategies and evidence gaps.

Main Methods:

  • Review of existing literature on the GH/IGF-1 axis in cardiovascular health and CHF.
  • Analysis of findings from placebo-controlled trials investigating GH therapy in CHF patients.
  • Discussion of factors influencing individual responsiveness to GH therapy.

Main Results:

  • Impaired GH/IGF-1 axis activity, characterized by low IGF-1, GH deficiency (GHD), and GH resistance, is frequently observed in CHF.
  • These abnormalities correlate with disease severity, poor clinical status, and adverse outcomes.
  • Clinical trials of GH therapy in CHF have yielded conflicting results, suggesting that the degree of GH/IGF-1 impairment influences treatment efficacy.

Conclusions:

  • The GH/IGF-1 axis plays a significant role in cardiovascular regulation and is dysregulated in CHF.
  • GH therapy's effectiveness in CHF is variable and may depend on the specific profile of GH/IGF-1 axis impairment.
  • Further research is needed to clarify therapeutic strategies, safety, and optimal patient selection for GH-based interventions in CHF.

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