Growth Hormone Replacement Therapy in Heart Failure With Reduced Ejection Fraction: A Randomized, Double-Blind,...

Area of Science:

• Cardiology
• Endocrinology
• Exercise Physiology

Background:

• Reduced activity of the growth hormone (GH)/insulin-like growth factor (IGF)-1 axis is common in heart failure (HF) and linked to poor outcomes.
• Preliminary studies suggest GH replacement may improve quality of life, cardiac function, and cardiovascular performance in HF patients.

Purpose of the Study:

• To evaluate the cardiovascular effects of 1-year GH replacement therapy in patients with heart failure and reduced ejection fraction (HFrEF) and concomitant GH deficiency (GHD).

Main Methods:

• A double-blind, randomized, placebo-controlled trial involving HFrEF patients (NYHA class I/II/III) with GHD.
• Patients received either GH or placebo for 1 year, alongside standard background therapy.
• Primary endpoint was peak oxygen consumption (VO2); secondary endpoints included hospitalizations, cardiac volumes, NT-proBNP, quality of life, and muscle strength.

Main Results:

• GH therapy significantly improved peak VO2 (P < 0.01) and other cardiopulmonary exercise parameters (P < 0.05).
• Improvements were observed in 6-minute walking distance (P < 0.05), handgrip strength (P < 0.01), and right ventricular function (P < 0.01).
• GH treatment led to amelioration of clinical status (NYHA class, P < 0.05), improved quality of life (P < 0.05), and reduced NT-proBNP levels (P < 0.05).

Conclusions:

• GH replacement therapy is effective in improving exercise performance in HFrEF patients with GHD.
• The therapy enhances both left and right ventricular structure and function, leading to better clinical status and quality of life.
• This study supports GH therapy as a beneficial treatment for HFrEF patients with GHD.