Haemodynamic effects of intravenous growth hormone in congestive heart failure

Volterrani, Maurizio; Desenzani, Paolo; Lorusso, Roberto; D’Aloia, Antonio; Manelli, Filippo; Giustina, Andrea

doi:10.1016/s0140-6736(97)24015-8

Cited by 118 publications

(43 citation statements)

References 5 publications

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“…On the other hand, GH activity has been proposed to be associated with myocardial growth and cardiac function. 22,23 It may be important to discriminate the relative role of released GH and ghrelin itself on the cardiovascular and sympathetic effects of ICV ghrelin. In regard to feeding behavior, GH release is not considered to be involved in the ghrelin-induced orexigenic effect, because ICV injection of ghrelin can increase food intake in GH-deficient spontaneous dwarf rats.…”

Section: Discussionmentioning

confidence: 99%

Central Ghrelin Modulates Sympathetic Activity in Conscious Rabbits

et al. 2002

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Abstract-Ghrelin is an orexigenic peptide originally isolated from the stomach. Intravenous administration of ghrelin has been shown to elicit a decrease in arterial pressure without a significant change in heart rate (HR), suggesting that ghrelin may act on the central nervous system to modulate sympathetic activity. The aim of the present study was to determine the central effects of ghrelin on cardiovascular and sympathetic responses in conscious rabbits. Key Words: baroreceptors Ⅲ blood pressure Ⅲ central nervous system Ⅲ ghrelin Ⅲ nervous system, sympathetic renal G hrelin, an acylated 28-residue peptide originally isolated from the rat stomach, is an endogenous ligand for the growth hormone (GH) secretagogue receptor. 1,2 Although ghrelin is likely to regulate pituitary GH secretion along with GH-releasing hormone and somatostatin, 2,3 GH secretagogue receptors have also been identified in hypothalamic neurons and in the brainstem. 4,5 Intracerebroventricular (ICV) administration of ghrelin has been shown to generate a dose-dependent increase in food intake and body weight, 6,7 suggesting that ghrelin participates in the regulation of food intake and GH secretion. Furthermore, ICV administration of ghrelin has been shown to increase plasma vasopressin level without a significant change in arterial pressure in conscious rats. 8 It has also been reported that intravenous injection of human ghrelin elicits a decrease in blood pressure without an increase in heart rate (HR) in healthy men. 9 In addition, plasma ghrelin concentration is increased in patients with cachexia associated with chronic heart failure. 10 These previous findings suggest that ghrelin may participate not only in feeding behavior but also in cardiovascular and sympathetic regulation. Although ghrelin has been reported to have a vasodilatory effect in humans, 11 the underlying mechanisms of depressor response induced by intravenous injection of ghrelin have not yet been determined. Because the depressor response was not accompanied by tachycardia, it is likely that mechanisms other than direct vasodilating effects, at least in part, are involved in this depressor response. To clarify the mechanisms for this depressor response, the effects of ghrelin on sympathetic activity and on the baroreceptor reflex should be determined. We hypothesized that intravenous administration of ghrelin acts at the central nervous system to modulate the sympathetic nervous system, resulting in a decrease in arterial pressure without tachycardia. Accordingly, in the present study, we focused on the central effect of ghrelin on sympathetic activity and baroreceptor reflex. To evaluate the sympathetic nervous system precisely, the present study was conducted on conscious rabbits with direct recording of renal sympathetic nerve activity (RSNA), because the sympathetic nervous system and baroreceptor reflex are greatly affected by anesthesia. 12,13

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Section: Discussionmentioning

confidence: 99%

Central Ghrelin Modulates Sympathetic Activity in Conscious Rabbits

et al. 2002

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“…An increased Ca 2þ responsiveness in cardiomyocytes has been suggested as an underlying cause (21). Acute improvement of cardiac index has been shown after continuous intravenous infusion of GH in men with chronic congestive heart failure, due to ischaemic or idiopathic causes, on unchanged heart failure medication (22). It was suggested that GH might have a place among inotropic drugs in the short-term treatment of chronic heart failure (22).…”

Section: Discussionmentioning

confidence: 99%

“…Acute improvement of cardiac index has been shown after continuous intravenous infusion of GH in men with chronic congestive heart failure, due to ischaemic or idiopathic causes, on unchanged heart failure medication (22). It was suggested that GH might have a place among inotropic drugs in the short-term treatment of chronic heart failure (22). Furthermore, in two men with end-stage heart failure due to ischaemic heart disease, an improvement was achieved within weeks on GH doses of 10 -14 IU/day subcutaneously; one patient was successfully bridged to transplantation and the other was delisted (23).…”

Section: Discussionmentioning

confidence: 99%

Is growth hormone deficiency contributing to heart failure in patients with beta-thalassemia major?

Erfurth

Holmer²,

Nilsson

et al. 2004

European Journal of Endocrinology

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A 21-year-old woman with b-thalassemia major (b-TM) and GH deficiency developed end-stage heart failure, New York Heart Association (NYHA) functional class IV, within 3 months after withdrawal of recombinant human growth hormone (GH). A myocardial biopsy excluded myocarditis and showed moderate iron deposit in the heart. Before her admission, intensified treatments with digoxin, angiotensin-converting enzyme inhibitor, diuretics and extra chelation therapy (desferrioxamine (DFO)) had not improved her progressive heart failure. At admission, GH was reinstituted together with intensified treatment of cardiac drugs and low doses of DFO, and her heart failure reversed. Four months later, NYHA functional class II was reached and within 1 year her cardiac function was normalised. We suggest that GH deficiency due to iron-induced damage to the hypothalamic -pituitary axis can contribute to heart failure in adult patients with b-TM. European Journal of Endocrinology 151 161-166

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“…Ciddi kalp yetmezlikliği olan 12 hastada ise kısa dönem intravenöz devamlı rekombinant human GH uygulanması ile 24 saatin sonunda ortalama kardiyak indeks başlangıç değerlerine göre %50 artarken, ortalama pulmoner arter basıncının % 25 düştüğü gösterilmiştir (10). Growth hormon biyolojik etkilerinin çoğunu hepatik ve periferal kaynaklı IGF-1 aracılığıyla yaparken kendi reseptörleriyle de etkileşerek doku düzeyinde direk etki edebilir (11).…”

Section: S Su Um MM Ma Ar Ry Yunclassified

Koroner Baypas Ameliyatı Geçiren İskemik Kardiyomyopatili Hastalarda Growth Hormon İnfüzyonunun Akut Hemodinamik Etkileri

Tuncay;ERYILMAZ¹

2002

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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A Am ma aç ç: : İskemik kardiyomyopatinin cerrahi tedavisi ciddi riskler taşımaktadır. Çalışmada, deprese ventriküllü hastalarda koroner arter bypass cerrahisi sonrası, growth hormon kullanımının kardiyak performansa etkisinin incelenmesini amaçladık.M Ma at te er ry ya al l--m me et to od d: : Kliniğimizde Haziran 1999 -Şubat 2001 tarihleri arasında elektif şartlarda koroner arter bypass cerrahisi uygulanan, deprese ventriküllü 80 hasta (ortalama EF:22%±5 ) çalışma kapsamına alınmıştır. Hastalar prospektif, randomize olarak iki gruba ayrılmış olup Grup I (38 hasta) konvansiyonel yöntemlere ek olarak kardiyopulmoner bypass'tan çıkmadan hemen önce Growth hormon infüzyonu alırken, Grup II (42 hasta) kontrol grubunu oluşturmuştur. Preoperatif dönemde profilaktik olarak grup 1'de 10 hastada ( %26.3) ve grup 2'de 11 hastada ( % 26.2) intraaortik balon pompası (IABP) yerleştirdik. Growth hormon ve kontrol grupları arasında preoperatif demografik ve hemodinamik parametreler ile operatif bulgular açısından bir farklılık yoktu. S So on nu uç ç: : Toplam mortalite %3.8 idi (Grup I: 1 hasta, % 2.6, Grup II: 2 hasta, %4.7, p=0.56). Postoperatif komplikasyonlar (aritmi, stroke, renal veya solunum yetmezliği, sternal enfeksiyon, uzamış solunum desteği) açısından her iki grup arasında anlamlı bir farklılık saptanmadı. Ancak, postoperatif ortalama dobutamin dozu (5±1.2µgr/kg/saat'e karşı 8±1.1µgr/kg/saat, p=0.01) ve IABP destek gereksinimi (18 e karşı 28, p=0.04) GH grubu hastalarında kontrol grubuna göre anlamlı olarak az bulunmuştur.T Ta ar rt tı ış şm ma a: : Koroner baypas operayonuna alınan depresif ventriküllü hastalarda proflaktik olarak uygulanan GH infüzyonu, olumsuz yan etki göstermeksizin postoperatif inotropik ilaç ve İABP gereksinimini azaltmaktadır.A An na ah ht ta ar r K Ke el li im me el le er r: : Koroner Arter Cerrahisi, Sol Ventrikül Disfonksiyonu, Growth Hormon, Itraaortik Balon Pompası. S SU UM MM MA AR RY YH He em mo od dy yn na am mi ic c E Ef ff fe ec ct ts s o of f G Gr ro ow wt th h H Ho or rm mo on ne e I In nf fu us si io on n I In n P Pa at ti ie en nt t W Wi it th h I Is sc ch he em mi ic c C Ca ar rd di io om my yo op pa at th hy y U Un nd de er rg go on ne e C Co or ro on na ar ry y A Ar rt te er ry y B By yp pa as ss s S Su ur rg ge er ry y. . B Ba ac ck kg gr ro ou un nd d: : Ischemic cardiomyopathy serious risk for surgical treatment in this study, we aimed to view the effect of growth hormone on cardiac performance in the patient with depressed ventricle after coronary surgery.M Ma at te er ri ia al l a an nd d M Me et th ho od d: :

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Haemodynamic effects of intravenous growth hormone in congestive heart failure

Cited by 118 publications

References 5 publications

Central Ghrelin Modulates Sympathetic Activity in Conscious Rabbits

Central Ghrelin Modulates Sympathetic Activity in Conscious Rabbits

Is growth hormone deficiency contributing to heart failure in patients with beta-thalassemia major?

Koroner Baypas Ameliyatı Geçiren İskemik Kardiyomyopatili Hastalarda Growth Hormon İnfüzyonunun Akut Hemodinamik Etkileri

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