title: Cardiomyocyte apoptosis is related to left ventricular dysfunction and remodelling in dilated cardiomyopathy, but is not affected by growth hormone treatment.
abstract: OBJECTIVE
  Cardiomyocyte apoptosis (CA) is a common feature of end-stage heart failure. We examined whether CA is associated with cardiac dysfunction and remodelling in heart failure due to dilated cardiomyopathy and studied the effect of human growth hormone (hGH) on CA.
  
  
  RESULTS
  We studied 38 patients, included in a phase III multi-center, randomised, double-blind and placebo-controlled trial of biosynthetic hGH treatment in dilated cardiomyopathy, at baseline and after 14 weeks treatment. Twenty-six patients received hGH and 12 received placebo. CA was quantified in endomyocardial biopsies using the TUNEL assay. CA correlated with left ventricular size (r=0.43, p=0.007). Compared to patients with CA below the median of 0.53%, patients with CA above the median had significantly larger left ventricular volumes and lower ejection fractions (EF) by echocardiography (median (interquartile range)) 200 ml (84) vs. 257 ml (134) and 27% (11) vs. 23% (9). Expression of the Fas receptor was associated with a high rate of CA. hGH treatment significantly increased serum IGF-1 levels, but it had no effect on CA or cardiac structure and function.
  
  
  CONCLUSIONS
  CA is related to left ventricular enlargement and dysfunction in dilated cardiomyopathy. CA is not affected by short-term treatment with hGH.
authors.affiliation: Department of Cardiology, Suedharz-Hospital, Robert-Koch-Strasse 39, 99734 Nordhausen, Germany. ibemw@web.de
authors.forename: Waltraut
authors.initials: W
authors.lastname: Ibe
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.forename: Stephan
authors.initials: S
authors.lastname: Lindemann
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bruder
authors.forename: Michael
authors.initials: M
authors.lastname: Buerke
authors.forename: Harald
authors.initials: H
authors.lastname: Darius
authors.forename: Kari
authors.initials: K
authors.lastname: Pulkki
authors.forename: Liisa-Maria
authors.initials: LM
authors.lastname: Voipio-Pulkki
mesh_terms: D017209:Apoptosis / Q000187:drug effects*; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects; D019382:Human Growth Hormone / Q000494:pharmacology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D032383:Myocytes, Cardiac / Q000187:drug effects*; D013002:Somatomedins; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
chemical_list: D013002:Somatomedins; D019382:Human Growth Hormone