Background: Preliminary results of GH deficiency (GHD) correction in HF showed an improvement in quality of life, cardiac structure and function, and cardiovascular performance.
Objectives: The present double-blind, randomized, placebo-controlled trial evaluated the cardiovascular effects of 1 year of GH replacement therapy in HFrEF.
Methods: Consecutive patients with HFrEF and concomitant GHD were recruited and randomized to receive GH (0.012 mg/kg every second day ~2.5 IU), or placebo, on top of background therapy. The primary endpoint was peak oxygen consumption (peak VO2). Secondary endpoints included hospitalizations, end-systolic LV volumes, NT-proBNP levels, Health-related Quality of Life score, and muscle strength (handgrip).
Results: The final study groups consisted of 30 patients randomized in the treatment group and 34 in the control group. After 1 year, 45 patients completed the study (24 vs 21 respectively). A statistically significant improvement of peak VO2 was reached in the active group (from 12.8±3.4 to 15.5±3.15 mL/Kg/min, p<0.01; ∆ peak VO2 between groups: +3.1 vs -1.8 p<0.01). Other CPET parameters (e.g., peak workload, and VE/VCO2 slope; p<0.05) also improved, paralleled by an increase in 6MWT distance (p<0.05) and handgrip strength (p<0.01). GH improved RV function (i.e., TAPSE and TAPSE/PASP ratio, p<0.01), leading to an amelioration of clinical status (NYHA class, p<0.05) and health-related quality of life (MLWHFQ, p<0.05). A significant decrease of NT-proBNP was also found (p<0.05).
Conclusions: GH replacement therapy in GHD-HFrEF patients improves exercise performance, and RV structure and function, leading to an amelioration of the clinical status and health-related quality of life.
Editors
JACC Heart Failure Editor-in-Chief
Biykem Bozkurt, MD, PhD, FACC
Deputy Editor
Akshay S. Desai, MD, MPH
JACC Heart Failure CME/MOC Editor
Kenneth A. Ellenbogen, MD
Author
Bhaskar Arora, MD, FACC
Important Dates
Date of Release: April 7, 2025
Term of Approval/Date of CME/MOC Expiration: April 6, 2026