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Endocrine Care: Philippe Le Corvoisier, Luc Hittinger, Philippe Chanson, Olivier Montagne, Isabelle Macquin-Mavier, and Patrick Maison Cardiac Effects of Growth Hormone Treatment in Chronic Heart Failure: A Meta-Analysis J Clin Endocrinol Metab 2007; 92: 180-185 [Abstract] [Full text] [PDF]

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E-Letter to the Editor: Effects of Growth Hormone Treatment in Chronic Heart Failure

Serafino Fazio, Flora Affuso, and Graziella Castellano.   (14 December 2006)

E-Letter to the Editor: Effects of Growth Hormone Treatment in Chronic Heart Failure 14 December 2006
Serafino Fazio, M.D. Department of Internal Medicine, University Federico II, via S. Pansini 5. 80131-Naples. Italy, Flora Affuso, and Graziella Castellano. Send letter to journal: Re: E-Letter to the Editor: Effects of Growth Hormone Treatment in Chronic Heart Failure fazio{at}unina.it Serafino Fazio, et al.	In their meta-analysis, LeCorvosier et al. (1) demonstrate that growth hormone (GH) improves relevant cardiovascular parameters in patients with chronic heart failure (CHF), supporting the concept that cardiovascular effects of GH are mediated by increased circulating IGF-1. Hopefully, their report will prompt a large randomized placebo- controlled study to verify the effects of long-term GH treatment in patients with CHF. However, any such study should consider the full spectrum of GH/IGF-1 axis abnormalities in CHF, ranging from severe GH deficiency to acquired GH resistance, and the consequent variability IGF-1 response to GH administration. LeCorvosier and colleagues reported that large IGF-1 increases (>89% from baseline) induced a significant overall effect, whereas smaller IGF-1 increases (<89% from baseline) had no impact – a finding that confirms our own in a previous trial of GH therapy for dilated cardiomyopathy (2). The meta-regression model of the study has also shown that changes in IGF-1 concentration significantly correlated with changes of relevant cardiovascular parameters. Thus, both LeCorvoisier and our findings suggest that in any future trial of GH therapy for CHF, patients should be tested to verify their IGF-1 response to GH before randomization, in order to define a GH dose that increases IGF-1 by at least 89%. References 1. LeCorvosier P, Hittinger L, Chanson P, Montagne O, Macquin-Mavier I, Maison P. Cardiac effects of growth hormone treatment in chronic heart failure. A meta-analysis. J Clin Endocrinol Metab. First published ahead of print October 24, 2006. 2. Fazio S, Sabatini D, Capaldo B, Vigorito C, Giordano A, Guida R, Pardo F, Biondi B, Saccà L. 1996. A preliminary study of growth hormone in the treatment of dilated cardiomyopathy. N Engl J Med 334:809-814