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Six Months of Recombinant Human GH Therapy in Patients with Ischemic Cardiac Failure Does Not Influence Left Ventricular Function and Mass

Departments of Endocrinology (J.W.A.S., Y.J.H.J., N.R.B., J.A.R., F.R.), Radiology (H.J.L., A.d.R.), Cardiology (E.E.v.d.W., J.J.B., H.W.V.), Nuclear Medicine (M.P.M.S.), Leiden University Medical Center, Leiden, The Netherlands Department of Cardiology, Groene Hart Hospital (E.V.), Gouda, The Netherlands

Address all correspondence and requests for reprints to: Jan W. A. Smit, M.D. Ph.D., Department of Endocrinology, C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. E-mail: j.w.a.smit.endo{at}lumc.nl

Abstract

Beneficial effects of recombinant human GH on cardiac function have been reported in humans with GH deficiency and in patients with idiopathic dilated cardiomyopathy. No randomized controlled trial has been performed on the effects of recombinant human GH on cardiac function in patients with ischemic cardiac failure. We therefore randomly assigned 22 patients with ischemic cardiac failure (left ventricular ejection fraction, <40%; 19 men and 3 women; mean age, 64 yr) to receive 6 months of unblinded therapy with recombinant human GH (2.0 IU/d) or no treatment. Primary end points were left ventricular ejection fraction and left ventricular mass. Left ventricular end-diastolic volume, left ventricular end-systolic volume, and myocardial perfusion, both at rest and during exercise, were assessed as well. Cardiac imaging techniques were electrocardiographically gated single photon emission computer tomography and magnetic resonance imaging. In addition, biochemical and biometric measurements were performed. Nineteen patients completed the study (10 controls and 9 GH-treated subjects). IGF-I and IGF-binding protein-3 increased significantly after recombinant human GH treatment (+24% and +58%, respectively) compared with control values (-14% and +5%; P < 0.05). Left ventricular ejection fraction, left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular mass, and myocardial perfusion were not influenced by recombinant human GH therapy. We conclude that 6 months of recombinant human GH treatment in patients with ischemic cardiac failure had no beneficial effect on left ventricular function and mass.

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