The growth hormone and insulin-like growth factor 1 axis in heart failure.
Experimental data suggests that growth hormone and IGF-1 have beneficial effects on myocardial function in animal models of heart failure. Preliminary evidence suggests an abnormality in the growth hormone-IGF-1 axis in heart failure with relative growth hormone resistance. Beneficial effects of growth hormone and IGF-1 include vasodilatation, stimulation of cardiac hypertrophy, increase in calcium sensitivity of cardiac myofilaments and prevention of apoptosis. Recently, cardiac cachexia has been shown to be a powerful negative predictive factor in heart failure. Cachectic patients have higher angiotensin II levels. In the rat there is an important interaction between the renin-angiotensin system and IGF-1. Thus, angiotensin II infusion causes weight loss in part through a catabolic effect. This effect results from increased protein degradation. Angiotensin II reduces circulating and skeletal muscle IGF-1 but increases IGF-1 and the IGF-IR expression in cardiac muscle. Preliminary data suggest a potential beneficial effect of growth hormone in heart failure. Further trials are necessary to test the potential beneficial effect of growth hormone and/or IGF-1 in heart failure.
Delafontaine
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Division of Cardiology, University Hospital, rue Micheli-du-Crest 24, 1211Geneva 14, Switzerland. Patrice.Delafontaine@hcuge.ch.
Brink
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M
D000818:Animals; D002100:Cachexia / Q000150:complications / Q000188:drug therapy; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D019382:Human Growth Hormone / Q000494:pharmacology / Q000502:physiology* / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000494:pharmacology / Q000502:physiology* / Q000627:therapeutic use
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I