© 2007 European Society of Cardiology
Cardiomyocyte apoptosis is related to left ventricular dysfunction and remodelling in dilated cardiomyopathy, but is not affected by growth hormone treatment
a Department of Cardiology, Suedharz-Hospital Robert-Koch-Strasse 39, 99734 Nordhausen, Germany
b Department of Cardiology, University of Mainz Langenbeckstrasse 1, 55101 Mainz, Germany
c Department of Anatomy, University of Turku Kiinamyllynkatu 10, 20520 Turku, Finland
d Department of Cardiology, University of Tübingen Otfried-Müller-Strasse 10, 72076 Tübingen, Germany
e Department of Cardiology, University of Halle-Wittenberg Universitätsplatz 10, 06108 Halle/Saale, Germany
f Department of Cardiology Vivantes Hospital Neukölln, Rudowerstrasse 48, 12351 Berlin, Germany
g Department of Laboratory Diagnostics, Helsinki University Central Hospital POB 340, 00029 Helsinki, Finland
h Department of Medicine, Helsinki University Central Hospital POB 340, 00029 Helsinki, Finland
* Corresponding author. Suedharz-Hospital, Dept. of Cardiology, Dr. Robert-Koch-Strasse 39, 99734 Nordhausen, Germany. Tel.: +49 363 1470918. E-mail address: ibemw{at}web.de
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Abstract |
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Background and aims: Cardiomyocyte apoptosis (CA) is a common feature of end-stage heart failure. We examined whether CA is associated with cardiac dysfunction and remodelling in heart failure due to dilated cardiomyopathy and studied the effect of human growth hormone (hGH) on CA.
Methods and results: We studied 38 patients, included in a phase III multi-center, randomised, double-blind and placebo-controlled trial of biosynthetic hGH treatment in dilated cardiomyopathy, at baseline and after 14 weeks treatment. Twenty-six patients received hGH and 12 received placebo. CA was quantified in endomyocardial biopsies using the TUNEL assay. CA correlated with left ventricular size (r=0.43, p=0.007). Compared to patients with CA below the median of 0.53%, patients with CA above the median had significantly larger left ventricular volumes and lower ejection fractions (EF) by echocardiography (median (interquartile range)) 200 ml (84) vs. 257 ml (134) and 27% (11) vs. 23% (9). Expression of the Fas receptor was associated with a high rate of CA. hGH treatment significantly increased serum IGF-1 levels, but it had no effect on CA or cardiac structure and function.
Conclusion: CA is related to left ventricular enlargement and dysfunction in dilated cardiomyopathy. CA is not affected by short-term treatment with hGH.
Key Words: Cardiomyocyte apoptosis • Heart failure • Dilated cardiomyopathy • Growth hormone • Insulin-like growth factor 1
Received November 18, 2005; Revised March 30, 2006; Accepted June 7, 2006
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