Effect of growth hormone treatment on circulating levels of NT-proBNP in patients with ischemic heart failure

• Published in: Growth hormone & IGF research Vol. 55; p. 101359
• Main Authors: Karason, Kristjan, Bobbio, Emanuele, Polte, Christian, Bollano, Entela, Peterson, Magnus, Cittadini, Antonio, Caidahl, Kenneth, Hjalmarson, Åke, Bengtsson, Bengt-Åke, Ekelund, Jan, Swedberg, Karl, Isgaard, Jörgen
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.12.2020
• Subjects: Cardiac and Cardiovascular Systems; Growth hormone; Heart failure; Insulin-like growth factor 1 (IGF-1); Ischemic heart disease; Kardiologi; Medicin och hälsovetenskap; N-terminal pro B-type natriuretic peptide (NT-proBNP); Heart failure; Ischemic heart disease; N-terminal pro B-type natriuretic peptide (NT-proBNP); Growth hormone; Insulin-like growth factor 1 (IGF-1)
• ISSN: 1096-6374; 1532-2238; 1532-2238
• DOI: 10.1016/j.ghir.2020.101359

Growth hormone (GH) therapy in heart failure (HF) is controversial. We investigated the cardiovascular effects of GH in patients with chronic HF due to ischemic heart disease. In a double-blind, placebo-controlled trial, we randomly assigned 37 patients (mean age 66 years; 95% male) with ischemic HF (ejection fraction [EF] < 40%) to a 9-month treatment with either recombinant human GH (1.4 mg every other day) or placebo, with subsequent 3-month treatment-free follow-up. The primary outcome was change in left ventricular (LV) end-systolic volume measured by cardiac magnetic resonance (CMR). Secondary outcomes comprised changes in cardiac structure and EF. Prespecified tertiary outcomes included changes in New York Heat Association (NYHA) functional class and quality of life (QoL), as well as levels of insulin-like growth factor-1 (IGF-1) and N-terminal pro-brain natriuretic peptide (NT-proBNP). No changes in cardiac structure or systolic function were identified in either treatment group; nor did GH treatment affect QoL or functional class. In the GH group, circulating levels of IGF-1 doubled from baseline (+105%; p < 0.001) and NT-proBNP levels halved (−48%; p < 0.001) during the treatment period, with subsequently a partial return of both towards baseline levels. No changes in IGF-1 or NT-proBNP were observed in the placebo group at any time during the study. In patients with chronic ischemic HF, nine months of GH treatment was associated with significant increases in levels of IGF-1 and reductions in levels of NT-proBNP, but did not affect cardiac structure, systolic function or functional capacity. •Although growth hormone (GH) exerts positive inotropic effects, its therapeutic value in heart failure (HF) is controversial.•Increased levels of NT-proBNP is a well-established biomarker for HF and predicts morbidity and mortality.•In the present study in patients with chronic ischemic HF, GH treatment did not alter left ventricular geometry or systolic function.•However, GH treatment reduced levels of NT-proBNP, suggesting an improvement in left ventricular diastolic function•Future studies with larger sample sizes are warranted to unravel the potential effect of GH on left ventricular structure and systolic function