title: Myths and truths of growth hormone and testosterone therapy in heart failure.
abstract: Heart failure is a chronic clinical syndrome with very poor prognosis. Despite being on optimal medical therapy, many patients still experience debilitating symptoms and poor quality of life. In recent years, there has been a great interest in anabolic hormone replacement therapy - namely, growth hormone and testosterone - as an adjunctive therapy in patients with advanced heart failure. It has been observed that low levels of growth hormone and testosterone have been associated with increased mortality and morbidity in patients with heart failure. Animal studies and clinical trials have shown promising clinical improvement with hormonal supplementation. Growth hormone has been shown to increase ventricular wall mass, decrease wall stress, increase cardiac contractility, and reduce peripheral vascular resistance, all of which might help to enhance cardiac function, resulting in improvement in clinical symptoms. Likewise, testosterone has been shown to improve hemodynamic parameters via reduction in peripheral vascular resistance and increased coronary blood flow through vasodilation, thereby improving functional and symptomatic status. To date, growth hormone and testosterone therapy have shown some positive benefits, albeit with some concerns over adverse effects. However, large randomized controlled trials are still needed to assess the long-term safety and efficacy.
authors.affiliation: Advanced Heart Failure and Heart Transplantation, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 6215, Los Angeles, CA 90048, USA.
authors.forename: Cam T
authors.initials: CT
authors.lastname: Nguyen
authors.forename: Alistair
authors.initials: A
authors.lastname: Aaronson
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Morrissey
authors.forename: Megha
authors.initials: M
authors.lastname: Agarwal
authors.forename: Robert D
authors.initials: RD
authors.lastname: Willix
authors.forename: Ernst R
authors.initials: ER
authors.lastname: Schwarz
mesh_terms: D000818:Animals; D013006:Growth Hormone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects; D011379:Prognosis; D011788:Quality of Life; D013739:Testosterone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D013739:Testosterone; D013006:Growth Hormone