Abstract
| Original language | English |
|---|---|
| Journal | PLoS One |
| Volume | 12 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2017 |
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Growth hormone deficiency is associated with worse cardiac function, physical performance, and outcome in chronic heart failure: Insights from the T.O.S.CA. GHD study. / Arcopinto, M.; Salzano, A.; Giallauria, Francesco; Bossone, Eduardo; Isgaard, Jörgen; Marra, A.M.; Bobbio, Emanuele; Vriz, Olga; Aberg, D.N.; Masarone, Daniele; De Paulis, Amato; Saldamarco, Lavinia; Vigorito, A. C.; Formisano, P.; Niola, Massimo; Perticone, F.; Bonaduce, D.; Saccà, L.; Colao, A.; Cittadini, Antonio.
In: PLoS One, Vol. 12, No. 1, 2017.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Growth hormone deficiency is associated with worse cardiac function, physical performance, and outcome in chronic heart failure: Insights from the T.O.S.CA. GHD study
AU - Arcopinto, M.
AU - Salzano, A.
AU - Giallauria, Francesco
AU - Bossone, Eduardo
AU - Isgaard, Jörgen
AU - Marra, A.M.
AU - Bobbio, Emanuele
AU - Vriz, Olga
AU - Aberg, D.N.
AU - Masarone, Daniele
AU - De Paulis, Amato
AU - Saldamarco, Lavinia
AU - Vigorito, A. C.
AU - Formisano, P.
AU - Niola, Massimo
AU - Perticone, F.
AU - Bonaduce, D.
AU - Saccà, L.
AU - Colao, A.
AU - Cittadini, Antonio
N1 - Export Date: 21 March 2017 CODEN: POLNC References: Sacca, L., Heart failure as a multiple hormonal deficiency syndrome (2009) Circulation. 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E10. , PMID: 11717621; Watanabe, S., Tamura, T., Ono, K., Insulin-like growth factor axis (insulin-like growth factor-I/insulinlike growth factor-binding protein-3) as a prognostic predictor of heart failure: Association with adiponectin (2010) Eur J Heart Fail, 12, pp. 1214-1222. , PMID: 20851819; Broglio, F., Fubini, A., Morello, M., Activity of GH/IGF-I axis in patients with dilated cardiomyopathy (1999) Clin Endocrinol, 50, pp. 417-430; Anwar, A., Gaspoz, J.M., Pampallona, S., Effect of congestive heart failure on the insulin-like growth factor-1 system (2002) Am J Cardiol, 90, pp. 1402-1405. , PMID: 12480057; Kontoleon, P.E., Anastasiou-Nana, M.I., Papapetrou, P.D., Hormonal profile in patients with congestive heart failure (2003) Int J Cardiol, 87, pp. 179-183. , PMID: 12559538; Corbalan, R., Acevedo, M., Godoy, I., Jalil, J., Campusano, C., Klassen, J., Enalapril restores depressed circulating insulin-like growth factor 1 in patients with chronic heart failure (1998) J Cardiac Fail, 4, pp. 115-119; Giustina, A., Veldhuis, J.D., Pathophysiology of the neuroregulation of growth hormone secretion in experimental animals and the human (1998) Endocrine Rev, 19, pp. 717-797; Mathews, L.S., Enberg, B., Norstedt, G., Regulation of rat growth hormone receptor gene expression (1989) J Biol Chem, 264 (17), pp. 9905-9910. , PMID: 2722883 Jun 15; Napoli, R., Guardasole, V., Matarazzo, M., Palmieri, E.A., Oliviero, U., Fazio, S., Saccà, L., Growth hormone corrects vascular dysfunction in patients with chronic heart failure (2002) J Am Coll Cardiol, 39 (1), pp. 90-95. , PMID: 11755292 Jan 2; Bhandari, S.S., Narayan, H., Jones, D.J., Suzuki, T., Struck, J., Bergmann, A., Squire, I.B., Ng, L.L., Plasma growth hormone is a strong predictor of risk at 1 year in acute heart failure (2016) Eur J Heart Fail, 18 (3), pp. 281-289. , PMID: 26670643 Mar; Broglio, F., Benso, A., Gottero, C., Vito, L.D., Aimaretti, G., Fubini, A., Patients with dilated cardiomyopathy show reduction of the somatotroph responsiveness to GHRH both alone and combined with arginine (2000) Eur J Endocrinol, 142, pp. 157-163. , PMID: 10664524; Arcopinto, M., Isgaard, J., Marra, A.M., Formisano, P., Bossone, E., Vriz, O., IGF-1 predicts survival in chronic heart failure. Insights from the T.O.S.CA. 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PY - 2017
Y1 - 2017
N2 - Background Although mounting evidence supports the concept that growth hormone (GH) deficiency (GHD) affects cardiovascular function, no study has systematically investigated its prevalence and role in a large cohort of chronic heart failure (CHF) patients. Aim of this study is to assess the prevalence of GHD in mild-to-moderate CHF and to explore clinical and functional correlates of GHD. Methods One-hundred thirty CHF patients underwent GH provocative test with GHRH+arginine and accordingly categorized into GH-deficiency (GHD, n = 88, age = 61.6±1.1 years, 68% men) and GH-sufficiency (GHS, n = 42, age = 63.6±1.5 years, 81% men) cohorts. Both groups received comprehensive cardiovascular examination and underwent Doppler echocardiography, cardiopulmonary exercise testing, and biochemical and hormonal assay. Results GHD was detected in roughly 30% of CHF patients. Compared to GHD, GHS patients showed smaller end-diastolic and end-systolic LV volumes (-28%, p = .008 and -24%, p = .015, respectively), lower LV end-systolic wall stress (-21%, p = .03), higher RV performance (+18% in RV area change, p = .03), lower estimated systolic pulmonary artery pressure (-11%, p = .04), higher peak VO2 (+20%, p = .001) and increased ventilatory efficiency (-12% in VE/VCO2 slope, p = .002). After adjusting for clinical covariates (age, gender, and tertiles of LV ejection fraction, IGF-1, peak VO2, VE/VCO2 slope, and NT-proBNP), logistic multivariate analysis showed that peak VO2 (β = -1.92, SE = 1.67, p = .03), VE/VCO2 slope (β = 2.23, SE = 1.20, p = .02) and NT-proBNP (β = 2.48, SE = 1.02, p = .016), were significantly associated with GHD status. Finally, compared to GHS, GHD cohort showed higher all-cause mortality at median follow-up of 3.5 years (40% vs. 25%, p < .001, respectively), independent of age, sex, NT-proBNP, peak VO2 and LVEF. Conclusions GH deficiency identifies a subgroup of CHF patients characterized by impaired functional capacity, LV remodeling and elevated NT-proBNP levels. GHD is also associated with increased all-cause mortality. © 2017 Arcopinto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
AB - Background Although mounting evidence supports the concept that growth hormone (GH) deficiency (GHD) affects cardiovascular function, no study has systematically investigated its prevalence and role in a large cohort of chronic heart failure (CHF) patients. Aim of this study is to assess the prevalence of GHD in mild-to-moderate CHF and to explore clinical and functional correlates of GHD. Methods One-hundred thirty CHF patients underwent GH provocative test with GHRH+arginine and accordingly categorized into GH-deficiency (GHD, n = 88, age = 61.6±1.1 years, 68% men) and GH-sufficiency (GHS, n = 42, age = 63.6±1.5 years, 81% men) cohorts. Both groups received comprehensive cardiovascular examination and underwent Doppler echocardiography, cardiopulmonary exercise testing, and biochemical and hormonal assay. Results GHD was detected in roughly 30% of CHF patients. Compared to GHD, GHS patients showed smaller end-diastolic and end-systolic LV volumes (-28%, p = .008 and -24%, p = .015, respectively), lower LV end-systolic wall stress (-21%, p = .03), higher RV performance (+18% in RV area change, p = .03), lower estimated systolic pulmonary artery pressure (-11%, p = .04), higher peak VO2 (+20%, p = .001) and increased ventilatory efficiency (-12% in VE/VCO2 slope, p = .002). After adjusting for clinical covariates (age, gender, and tertiles of LV ejection fraction, IGF-1, peak VO2, VE/VCO2 slope, and NT-proBNP), logistic multivariate analysis showed that peak VO2 (β = -1.92, SE = 1.67, p = .03), VE/VCO2 slope (β = 2.23, SE = 1.20, p = .02) and NT-proBNP (β = 2.48, SE = 1.02, p = .016), were significantly associated with GHD status. Finally, compared to GHS, GHD cohort showed higher all-cause mortality at median follow-up of 3.5 years (40% vs. 25%, p < .001, respectively), independent of age, sex, NT-proBNP, peak VO2 and LVEF. Conclusions GH deficiency identifies a subgroup of CHF patients characterized by impaired functional capacity, LV remodeling and elevated NT-proBNP levels. GHD is also associated with increased all-cause mortality. © 2017 Arcopinto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
U2 - 10.1371/journal.pone.0170058
DO - 10.1371/journal.pone.0170058
M3 - Article
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 1
ER -