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Randomised, double-blind, placebo-controlled trial of human recombinant growth hormone in patients with chronic heart failure due to dilated cardiomyopathy

Item Type:Article
Title:Randomised, double-blind, placebo-controlled trial of human recombinant growth hormone in patients with chronic heart failure due to dilated cardiomyopathy
Creators Name:Osterziel, K.J. and Strohm, O. and Schuler, J. and Friedrich, M. and Haenlein, D. and Willenbrock, R. and Anker, S.D. and Poole-Wilson, P.A. and Ranke, M.B. and Dietz, R.
Abstract:BACKGROUND: Some studies have suggested that treatment with recombinant human growth hormone (rhGH) increases left-ventricular mass and improves haemodynamic and functional status in patients with heart failure due to dilated cardiomyopathy. We did a double-blind, randomised, placebo-controlled study of rhGH in patients with chronic heart failure due to dilated cardiomyopathy. METHODS: 50 patients (43 men) were randomly allocated treatment with subcutaneous rhGH (2 IU daily) or placebo for a minimum of 12 weeks. The primary endpoints were the effects on left-ventricular mass and systolic wall stress. The secondary endpoints were the effects on left-ventricular size and function. Data were analysed by intention to treat. FINDINGS: Patients in the rhGH group had an increase in left-ventricular mass compared with those in the placebo group (27%, p=0.0001). There was no significant difference in left-ventricular systolic wall stress, mean blood pressure, or systemic vascular resistance between the two groups. New York Heart Association functional class, left-ventricular ejection fraction, and distance on the 6 min walking test were unchanged. The change in serum insulin-like growth factor (IGF)-I concentrations (rhGH 77 ng/mL; placebo -19 ng/mL, GH vs placebo p=0.0001) was significantly related to the change in left-ventricular mass (r=0.55, p=0.0001). One patient in the rhGH group was withdrawn at 6 weeks because of worsening heart failure. INTERPRETATION: There is a significant increase in left-ventricular mass in patients with dilated cardiomyopathy given rhGH but this is not accompanied by an improvement in clinical status. Changes in left-ventricular mass are related to changes in serum IGF-I concentrations. Whether a longer treatment period would provide clinical benefits and decrease mortality is unknown.
Keywords:Dilated Cardiomyopathy, Double-Blind Method, Growth Hormone, Heart Failure, Heart Ventricles, Left Ventricular Hypertrophy, Insulin-Like Growth Factor Binding Protein 3, Insulin-Like Growth Factor I, Stroke Volume, Left Ventricular Function
Source:Lancet
ISSN:0140-6736
Publisher:Lancet (U.K.)
Volume:351
Number:9111
Page Range:1233-1237
Date:25 April 1998
Official Publication:https://doi.org/10.1016/S0140-6736(97)11329-0
PubMed:View item in PubMed

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