Growth Hormone Replacement Delays the Progression of Chronic Heart Failure Combined With Growth Hormone Deficiency An Extension of a Randomized Controlled Single-Blind Study

被引：66

作者：

Cittadini, Antonio ^{[1
]}

Marra, Alberto M. ^{[1
]}

Arcopinto, Michele ^{[1
]}

Bobbio, Emanuele ^{[1
]}

Salzano, Andrea ^{[1
]}

Sirico, Domenico ^{[1
]}

Napoli, Raffaele ^{[1
]}

Colao, Annamaria ^{[2
]}

Longobardi, Salvatore ^{[3
]}

Baliga, Ragavendra R. ^{[4
]}

Bossone, Eduardo ^{[5
]}

Sacca, Luigi ^{[1
]}

机构：

[1] Univ Naples Federico II, Dept Internal Med Cardiovasc & Immunol Sci, I-80131 Naples, Italy

[2] Univ Naples Federico II, Dept Mol & Clin Endocrinol & Oncol, I-80131 Naples, Italy

[3] Merck Serono SpA, Med Liaison Off, Rome, Italy

[4] Ohio State Univ, Div Cardiovasc Med, Columbus, OH 43210 USA

[5] Univ Salerno, Heart Dept, Div Cardiol, Cava dei Tirreni Amalfi Coast Hosp, I-84100 Salerno, Italy

来源：

JACC-HEART FAILURE | 2013年 / 1卷 / 04期

关键词：

chronic heart failure; GH replacement; longterm;

D O I：

10.1016/j.jchf.2013.04.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study sought to evaluate the efficacy and safety of long-term growth hormone (GH) replacement therapy in GH-deficient patients with chronic heart failure (CHF). Background Recent evidence indicates that growth hormone deficiency (GHD) affects as many as 40% of patients with CHF, and short-term GH replacement causes functional benefit. Whether long-term GH replacement also affects CHF progression is unknown. Methods The study is an extension of a previous randomized, controlled single-blind trial that screened 158 consecutive CHF patients (New York Heart Association classes II to IV) and identified 63 who had GHD by the growth hormone releasing hormone plus arginine test. Fifty-six patients were randomized to receive either GH therapy or standard CHF therapy. Patients were evaluated at baseline and after a 4-year follow-up. The primary endpoint was peak oxygen consumption (VO2). Secondary endpoints included left ventricular (LV) ejection fraction and volumes, serum amino terminal fragment of the pro-hormone brain-type natriuretic peptide, quality of life, and safety. Results Seventeen patients in the GH group and 14 in the control group completed the study. In the GH group, peak VO2 improved over the 4-year follow-up. The treatment effect was 7.1 +/- 0.7 ml/kg/min versus -1.8 +/- 0.5 ml/kg/min in the GH and control groups, respectively. At 4 years, LV ejection fraction increased by 10 +/- 3% in the GH group, whereas it decreased by 2 +/- 5% in control patients. The treatment effect on LV end-systolic volume index was -22 +/- 6 ml and 8 +/- 3 ml/m(2) in the GH and control groups, respectively (all p < 0.001). No major adverse events were reported in the patients who received GH. Conclusions Although this is a preliminary study, the finding suggests a new therapeutic approach to a large proportion of GHD patients with CHF. (C) 2013 by the American College of Cardiology Foundation

引用

页码：325 / 330

页数：6

共 32 条

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