Growth hormone therapy in heart failure.
Clinical and experimental data in animals and patients with endstage heart failure due to dilated cardiomyopathy or ischemic heart disease suggest a beneficial role of growth factors like human recombinant growth hormone or insulin-like growth factor I. Their cardiac effects are an increase in myocardial mass and a decrease in systolic wall stress. Based on the results of animal studies and of preliminary studies in patients with dilated cardiomyopathy, double-blind and placebo-controlled studies have proven the increase in myocardial mass and a significant reduction of left ventricular wall stress, as demonstrated by magnetic resonance imaging.The risk of the additional therapy with human growth factors in this high-risk group of patients with a high mortality is justified, if this new approach becomes a possible alternative to cardiac transplantation or a bridge toward transplantation.If future randomized studies in larger patient groups with an individualized substitution therapy with growth hormone and/or IGF-I can demonstrate a beneficial effect on mortality and morbidity, this new therapeutic approach could become an attractive alternative in these high-risk patients.
Charité, Franz-Volhard-Klinik am Max-Delbrück-Centrum, Wiltbergstr. 50, D-13125 Berlin, Germany, e-mail: strohm@fvk-berlin.de, Germany.
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O
Strohm
Charité, Franz-Volhard-Klinik am Max-Delbrück-Centrum, Wiltbergstr. 50, D-13125 Berlin, Germany, e-mail: strohm@fvk-berlin.de, Germany.
M G
MG
Friedrich
Charité, Franz-Volhard-Klinik am Max-Delbrück-Centrum, Wiltbergstr. 50, D-13125 Berlin, Germany, e-mail: strohm@fvk-berlin.de, Germany.
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V Harsdorf
Charité, Franz-Volhard-Klinik am Max-Delbrück-Centrum, Wiltbergstr. 50, D-13125 Berlin, Germany, e-mail: strohm@fvk-berlin.de, Germany.
K J
KJ
Osterziel
Charité, Franz-Volhard-Klinik am Max-Delbrück-Centrum, Wiltbergstr. 50, D-13125 Berlin, Germany, e-mail: strohm@fvk-berlin.de, Germany.
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Dietz
Key words Heart failure – IGF-I – growth hormone – dilated cardiomyopathy – review