Evaluation of growth hormone administration in patients with chronic heartfailure secondary to coronary artery disease

We have examined the effects of 6 months of treatment with growth hormone ( GH) (0.02 U/kg/day) in 10 patients with chronic postischemic cardiac failur e. Ten patients matched for age, body mass index, functional class, and ele ction fraction served as a control group. In the GH group, 1 patient died a nd 2 were withdrawn from the study because of arrhythmia or worsening of he art failure. In the control group, 1 patient died and 1 patient was withdra wn from the study because of progressive heart failure. Among GH patients, those with an unfavorable outcome had a greater left ventricular end-diasta lic diameter (79, 82, and 88 mm) on entry to the study than patients withou t adverse events (range 62 to 72 mm). At the end of the study, the seven GH patients reported a feeling of well-being and had a significant increase i n their exercise test duration (462 +/- 121 vs 591 +/- 105 seconds, p < 0.0 5). Low baseline insulin-like growth factor-1 values were increased with GH treatment (189 +/- 52 vs 100 +/- 22 ng/ml, p < 0.01). GH did not change le ft ventricular diameters or wall thickness. A trend toward decreased serum triglyceride levels and adipose body tissue associated with an increase in high-density lipoproteins was observed in the GH group. In conclusion, our present data support previous suggestions that GH treatment exerts some ben eficial effects in patients with chronic, stabilized, moderately severe hea rt failure, but may have deleterious effects in patients with more severe h eart failure. (C) 1999 by Excerpta Medica, Inc.