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[Growth hormone deficiency in patients with chronic heart failure]
M Acevedo1, R Corbalán, I Godoy
1Departamento de Enfermedades Cardiovasculares, Hospital Clínico, Universidad Católica de Chile, Santiago, Chile.
Insights
Patients with chronic heart failure exhibit significantly lower growth hormone and IGF-1 levels. This finding suggests a potential role for the growth hormone-IGF-1 axis in heart failure pathophysiology.
Area of Science:
- Endocrinology
- Cardiology
Context:
- Growth hormone (GH) demonstrates positive inotropic effects and peripheral vasodilatation in preliminary studies.
- Limited data exists on the GH-IGF-1 axis activity in chronic heart failure (CHF) patients.
Purpose:
- To quantify GH and Insulin-like Growth Factor 1 (IGF-1) levels in individuals with CHF.
Summary:
- Nine CHF patients (ages 49-76, 7 male) with dilated cardiomyopathy or coronary heart disease were assessed.
- Measurements included thyroid hormones, basal and exercise GH and IGF-1, left ventricular ejection fraction, and nutritional status.
- Results indicated normal thyroid hormones and nutritional markers, but significantly lower exercise GH and IGF-1 levels compared to reference values.
Impact:
- CHF patients present with subnormal GH and IGF-1 levels.
- This highlights a potential endocrine dysfunction in chronic heart failure.
Background:
Experimental and preliminary clinical data in patients with dilated cardiomyopathy show that growth hormone has a positive inotropic effect and contributes to peripheral vasodilatation. However, there is little information about the activity of growth hormone-IGF-1 axis in patients with chronic heart failure.
Aim:
To measure growth hormone and IGF-1 levels in patients with chronic heart failure.
Patients And Methods:
Nine patients, aged 49 to 76 years old, 7 male, were studied. Seven had an idiopathic dilated cardiomyopathy and 2 a coronary heart disease. All had a stable cardiac failure, in functional capacity II or III and were receiving digoxin, furosemide and potassium supplements. Thyroid hormone levels, basal and exercise growth hormone and IGF-1 levels were measured and compared with reference values for American populations. Left ventricular ejection fraction was measured with an isotopic technique and nutritional status using anthropometry and indirect calorimetry.
Results:
Anthropometric measures, basal and post-prandial oxygen consumption were within normal limits. Thyroid hormone levels were normal. During maximal exercise, growth hormone levels were 2.56 +/- 4.1 ng/ml and IGF-1 levels were 0.56 +/- 0.61 mU/ml. These values were significantly lower than expected for age and sex.
Conclusions:
These patients with chronic cardiac failure have lower than normal growth hormone and IGF-1 levels.