European Journal of Heart Failure Advance Access published online on April 19, 2009
European Journal of Heart Failure, doi:10.1093/eurjhf/hfp044
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Growth hormone resistance in severe heart failure resolves after cardiac transplantation
1 Department of Cardiology, Karolinska University Hospital, N305, 171 76 Stockholm, Sweden
2 Division of Endocrinology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
3 Division of Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
4 Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
5 Salisbury University, Salisbury, MD, USA
6 Department of Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, LA, USA
* Corresponding author. Tel: +46 8 51774975, Fax: +46 8 311044, Email: lars.lund{at}alumni.duke.edu
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Abstract |
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Aims: Severe heart failure (HF) is associated with cachexia; this is often reversed post cardiac transplantation (HTx) with frequent development of obesity. Growth hormone (GH) resistance is common in HF and may contribute to cachexia. Whether GH resistance resolves post HTx is unknown. We aimed to confirm that HF is associated with GH resistance and to test the hypothesis that GH resistance resolves post HTx.
Methods and results: We measured GH, insulin-like growth factor-1 (IGF-1), and body composition in 10 HF patients awaiting HTx, in 18 patients 11 ± 8 months post HTx, and seven controls. Body mass index was 23.5 ± 3.2 in HF patients and 29.3 ± 5.7 post HTx. HTx patients had gained 14 ± 8 kg since HTx. GH was elevated in HF (control: 0.21 ± 0.25; HF: 1.13 ± 1.19; HTx: 0.11 ± 0.13 ng/mL; P < 0.007), while IGF-1 was higher in HTx (control: 114 ± 57; HF: 94 ± 52; HTx: 190 ± 106 ng/mL; P < 0.02). HTx had higher total body and abdominal fat %.
Conclusion: GH resistance is present in severe HF and resolves post HTx. These findings should be confirmed through larger trials.
Key Words: Heart failure • Cachexia • Cardiac transplantation • Growth hormone • Insulin-like growth factor-1
Received November 21, 2008; Revised January 31, 2009; Accepted February 4, 2009
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  L. H. Lund, J. J. Williams, P. Freda, J. J. LaManca, T. H. LeJemtel, and D. M. Mancini Ghrelin resistance occurs in severe heart failure and resolves after heart transplantation Eur J Heart Fail, August 1, 2009; 11(8): 789 - 794. [Abstract] [Full Text] [PDF]
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