GROWTH-HORMONE DEFICIENCY IN PATIENTS WIT H CHRONIC HEART-FAILURE

Background: Experimental and preliminary clinical data in patients wit h dilated cardiomyopathy show that growth hormone has a positive inotr opic effect and contributes to peripheral vasodilatation. However, the re is little information about the activity of growth hormone-IGF-1 ax is in patients with chronic heart failure. Aim: To measure growth horm one and IGF-1 levels in patients with chronic heart failure. Patients and methods: Nine patients, aged 49 to 76 years old, male, were studie d. Seven had an idiopathic dilated cardiomyopathy and 2 a coronary hea rt disease. All had a stable cardiac failure, in functional capacity I I or III and were receiving digoxin, furosemide and potassium suppleme nts. Thyroid hormone levels, basal and exercise growth hormone and IGF -1 levels were measured and compared with reference values for America n populations. Left ventricular ejection fraction was measured with an isotopic technique and nutritional status using anthropometry and ind irect calorimetry. Results: Anthropometric measures, basal and post-pr andial oxygen consumption were within normal limits. Thyroid hormone l evels were normal. During maximal exercise, growth hormone levels were 2.56 +/- 4.1 ng/ml and IGF-1 levels were 0.56 +/- 0.61 mU/ml. These v alues were significantly lower than expected for age and sex. Conclusi ons: These patients with chronic cardiac failure have lower than norma l growth hormone and IGF-1 levels.