Growth Hormone Replacement Therapy in Heart Failure With Reduced Ejection Fraction: A Randomized, Double-Blind, Placebo-Controlled Trial (JACC Heart Failure April 2025)-Article: Growth Hormone Replacement Therapy in Heart Failure With Reduced Ejection Fraction: A Randomized, Double-Blind, Placebo-Controlled Trial

Article: Growth Hormone Replacement Therapy in Heart Failure With Reduced Ejection Fraction: A Randomized, Double-Blind, Placebo-Controlled Trial

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The study investigates the effects of growth hormone (GH) replacement therapy on patients with heart failure with reduced ejection fraction (HFrEF) and concurrent growth hormone deficiency (GHD). The randomized, double-blind, placebo-controlled trial enrolled 86 GHD patients from an initial 318 screened over 36 months. A total of 64 participants were divided into a treatment group receiving GH and a control group receiving a placebo for one year. The primary endpoint was peak oxygen consumption (VO2), with secondary endpoints including hospitalizations, left ventricular volumes, NT-proBNP levels, quality of life scores, and muscle strength.<br /><br />The results showed significant improvements in the GH treatment group, including a 22% increase in peak VO2 (P = 0.01), enhanced cardiopulmonary parameters, exercise capacity, and muscle strength, as well as an augmentation of both left and right ventricular function. GH therapy led to a reduction in NT-proBNP levels and improved right ventricular function and quality of life (P < 0.05). The improvement in heart function and exercise capacity was attributed to GH's effects on myocardial growth and cardiopulmonary performance.<br /><br />The trial also highlighted the high prevalence of GHD in heart failure patients and emphasized its potential as a treatable condition with appropriate GH replacement therapy. This treatment is safe and well-tolerated and led to marked improvements in clinical outcomes and quality of life. However, larger studies are needed to confirm these findings and potentially revise clinical guidelines regarding the management of HFrEF with GH replacement therapy. Overall, findings suggest that HFrEF patients should be screened for GHD as part of their management protocol.

Keywords

growth hormone replacement

heart failure

reduced ejection fraction

growth hormone deficiency

randomized controlled trial

peak oxygen consumption

cardiopulmonary performance

NT-proBNP levels

quality of life

muscle strength