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Growth Hormone Defi...
Growth Hormone Deficiency Is Associated with Worse Cardiac Function, Physical Performance, and Outcome in Chronic Heart Failure: Insights from the TOSCA. GHD Study
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Arcopinto, M. (author)
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Salzano, A. (author)
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Giallauria, F. (author)
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Bossone, E. (author)
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- Isgaard, Jörgen, 1959 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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Marra, A. M. (author)
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Bobbio, Emanuele (author)
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Vriz, O. (author)
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- Åberg, N David, 1970 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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Masarone, D. (author)
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De Paulis, A. (author)
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Saldamarco, L. (author)
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Vigorito, C. (author)
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Formisano, P. (author)
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Niola, M. (author)
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Perticone, F. (author)
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Bonaduce, D. (author)
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Sacca, L. (author)
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Colao, A. (author)
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Cittadini, A. (author)
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Tosca Trattamento Ormonale Scompen, Tosca Trattamento Ormonale Scompen (author)
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(creator_code:org_t)
- 2017-01-17
- 2017
- English.
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In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:1
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Abstract
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- 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. 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. 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 (beta = -1.92, SE = 1.67, p=.03), VE/VCO2 slope (beta = 2.23, SE = 1.20, p=.02) and NT-proBNP (beta = 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. 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine (hsv//eng)
Keyword
- factor-i
- dilated cardiomyopathy
- anabolic deficiency
- anaerobic
- threshold
- binding protein-3
- therapy
- axis
- hypopituitarism
- depression
- predictor
- Science & Technology - Other Topics
Publication and Content Type
- ref (subject category)
- art (subject category)
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Plos One
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- By the author/editor
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Arcopinto, M.
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Salzano, A.
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Giallauria, F.
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Bossone, E.
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Isgaard, Jörgen, ...
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Marra, A. M.
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show more...
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Bobbio, Emanuele
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Vriz, O.
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Åberg, N David, ...
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Masarone, D.
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De Paulis, A.
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Saldamarco, L.
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Vigorito, C.
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Formisano, P.
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Niola, M.
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Perticone, F.
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Bonaduce, D.
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Sacca, L.
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Colao, A.
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Cittadini, A.
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Tosca Trattament ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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Plos One
- By the university
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University of Gothenburg