Experimental and clinical studies have shown that the administration of recombinant
human growth hormone can improve deteriorated left ventricular function and hemodynamics in patients with
heart failure. Herein, we compared the effects of
growth hormone versus placebo upon resting left ventricular ejection fraction, exercise capacity and neurohormonal status in patients with advanced
heart failure. Nineteen patients with advanced cardiac
heart failure (ejection fraction <30%) were studied at baseline and after 8 weeks of treatment with
growth hormone (0.03 U/kg per day) or placebo. Primary end points were resting left ventricular ejection fraction, peak oxygen consumption and neurohormonal status, including plasma
norepinephrine levels and
insulin like growth factor-1 and its binding protein-3. Results are presented as median and interquartile ranges. Patients receiving
growth hormone had a significant increase in
insulin growth factor-1 plasma levels (median difference
growth hormone=83 ng/ml [57-170] versus placebo=-6 ng/
ml [-23-6], P<0.05) and its binding protein-3. However, no significant increase in left ventricular ejection fraction after
growth hormone treatment (ejection fraction pre=16% [13-18] and post=17% [14-27]) was noticed when compared to placebo (ejection fraction pre=20% [15-24] and post=20% [15-26]). Also, no significant effect of
growth hormone treatment was seen on peak oxygen consumption or
norepinephrine plasma levels. Although the administration of
growth hormone to patients with advanced cardiac
heart failure was associated with a significant increase in
insulin growth factor-1, there were no significant changes in ejection fraction, exercise capacity and/or neurohormonal status.