© 2002 European Society of Cardiology
GH-independent cardiotropic activities of hexarelin in patients with severe left ventricular dysfunction due to dilated and ischemic cardiomyopathy
a Division of Cardiology University Internal Medicine Department, Turin, Italy
b Division of Endocrinology University Internal Medicine Department, Turin, Italy
c Division of Nuclear Medicine University Internal Medicine Department, Turin, Italy
* Corresponding author. Divisione Universitaria di Cardiologia, Dipartimento di Medicina Interna, Ospedale ‘Molinette’ corso Dogliotti 14, 10126 Torino, Italy. Tel.: +39-011-633-4028; fax: +39-011-696-7053. E-mail address: marcobobbio{at}libero.it
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Abstract |
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Aim: To investigate acute cardiotropic activities of hexarelin in patients with severe left ventricular dysfunction due to ischemic (iCMP) and dilated cardiomyopathy (dCMP).
Methods and results: We studied the effect of intravenous hexarelin administration on growth hormone (GH) levels and left ventricular ejection fraction (LVEF) evaluated by radionuclide angiography in eight patients with dCMP (age 53.0±2.8, LVEF 16.7±2.1%) and five patients with iCMP (age 52.0±2.8 years, LVEF 22.6±2.1). Results were compared with a group of seven normal subjects (age 37.4±3.4 years, LVEF 64.0±1.5%) and seven patients with severe growth-hormone deficiency (GHD; age 42.0±4.4 years, LVEF 50.0±1.9%) previously studied with the same methodology. In dCMP and iCMP patients hexarelin induced a similar significant (P<0.05) increase in GH levels. In iCMP patients hexarelin induced a LVEF increase (peak LVEF 26.2±2.5%, P<0.05) as observed in normals and GHD, while in dCMP LVEF was unchanged (peak LVEF 17.7±1.7, P = NS). In all groups other hemodynamic parameters were unchanged.
Conclusions: Acute hexarelin administration increases LVEF in iCMP patients (as in normals and GHD) but not in dCMP patients in spite of a similar GH releasing effect and basal LVEF. A possible explanation of the positive inotropic effect of hexarelin in iCMP could be a direct stimulation on viable myocardium or myocardial contractile reserve.
Key Words: Growth hormone • Growth hormone secretagogues • Hexarelin • Ischemic cardiomyopathy • Dilated cardiomyopathy
Received August 21, 2001; Accepted September 13, 2001
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