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Growth hormone therapy in heart failure
O Strohm1, M G Friedrich1, R V Harsdorf1
1Charité, Franz-Volhard-Klinik am Max-Delbrück-Centrum, Wiltbergstr. 50, D-13125 Berlin, Germany, e-mail: strohm@fvk-berlin.de, Germany.
Insights
Growth factors like human growth hormone may improve heart function in severe heart failure by increasing heart muscle mass and reducing stress. This therapy could be an alternative to heart transplantation for high-risk patients.
Area of Science:
- Cardiology
- Endocrinology
- Regenerative Medicine
Background:
- Severe heart failure, including dilated cardiomyopathy and ischemic heart disease, presents significant challenges.
- Growth factors, such as human growth hormone (hGH) and insulin-like growth factor I (IGF-I), have shown potential in preclinical and preliminary clinical studies.
- These factors may exert beneficial cardiac effects, including increased myocardial mass and reduced systolic wall stress.
Purpose of the Study:
- To evaluate the efficacy of human growth factors in patients with end-stage heart failure.
- To assess the impact of growth factor therapy on myocardial mass and left ventricular wall stress.
Main Methods:
- Double-blind, placebo-controlled studies were conducted.
- Magnetic resonance imaging (MRI) was utilized to assess cardiac parameters.
- Patient populations included those with dilated cardiomyopathy and ischemic heart disease.
Main Results:
- Growth factor therapy led to a significant increase in myocardial mass.
- A significant reduction in left ventricular wall stress was observed, confirmed by MRI.
- Preliminary studies in dilated cardiomyopathy patients showed promising results.
Conclusions:
- Human growth factors demonstrate a potential therapeutic role in managing end-stage heart failure.
- This approach may serve as a viable alternative or bridge therapy to cardiac transplantation.
- Further randomized trials are warranted to confirm effects on mortality and morbidity in larger patient cohorts.
Abstract:
Clinical and experimental data in animals and patients with endstage heart failure due to dilated cardiomyopathy or ischemic heart disease suggest a beneficial role of growth factors like human recombinant growth hormone or insulin-like growth factor I. Their cardiac effects are an increase in myocardial mass and a decrease in systolic wall stress. Based on the results of animal studies and of preliminary studies in patients with dilated cardiomyopathy, double-blind and placebo-controlled studies have proven the increase in myocardial mass and a significant reduction of left ventricular wall stress, as demonstrated by magnetic resonance imaging.The risk of the additional therapy with human growth factors in this high-risk group of patients with a high mortality is justified, if this new approach becomes a possible alternative to cardiac transplantation or a bridge toward transplantation.If future randomized studies in larger patient groups with an individualized substitution therapy with growth hormone and/or IGF-I can demonstrate a beneficial effect on mortality and morbidity, this new therapeutic approach could become an attractive alternative in these high-risk patients.
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