GH Therapy in Chronic Heart Failure: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Open accessAbstract
Context: Guideline-directed medical therapy of heart failure (HF) primarily targets neurohormonal activation. However, GH has emerged as a potential treatment for the multiple hormonal deficiency syndrome, which is associated with worse outcomes in HF. Objective: This study evaluates the efficacy and safety of GH therapy in HF. Data Sources: A systematic search was conducted in PubMed, Cochrane Library, and ClinicalTrials.gov, according to PRISMA guidelines Study Selection: Randomized, placebo-controlled trials studying GH therapy in adult HF patients were included. Of the 1184 initially identified records, 17 studies (1.4%) met the inclusion criteria. Data extraction: Two independent authors conducted the search, with any disagreements resolved by a third author. Study quality was assessed using predefined criteria, including randomization, blinding, and the presence of a placebo group. Data Synthesis: A random-effects model was applied due to heterogeneity across studies. GH therapy significantly improved left ventricular ejection fraction (+3.34%; 95% CI, 1.09-5.59; P = .0037), peak oxygen consumption (+2.84 mL/kg/min; 95% CI, 1.32-4.36; P = .0002), and New York Heart Association class (−0.44; 95% CI, −0.08 to −0.81; P = .023). GH therapy also reduced the composite of death, worsening HF or ventricular tachycardia by 41% (RR = .59; 95% CI, 0.39-0.90; P = .013). Subgroup analyses indicated that patients with ischemic cardiomyopathy, baseline ejection fraction ≥30%, and longer treatment duration experienced greater benefits. Conclusion: GH therapy demonstrated improvements in cardiac function, exercise capacity, and HF symptoms, along with a statistically significant trend toward improvements in hard endpoints. Event-driven trials are needed to validate these findings.
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Growth hormone levels may increase with caloric restriction, stimulating lipolysis and reducing muscle protein breakdown by inhibiting the effects of cortisol.
“Growth hormone (GH) levels may increase with caloric restriction, stimulating lipolysis and reducing muscle protein breakdown by inhibiting the effects of cortisol.”
From Beyond Calories: Individual Metabolic and Hormonal Adaptations Driving Variability in Weight Management—A State-of-the-Art Narrative Review (2024) · cites this paper as [21]
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- Authors
- Theodorakis, N., Feretzakis, G., Kreouzi, M., Anagnostou, D., Hitas, C., Verykios, V. S., & Nikolaou, M.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Hellenic Open University (GR)
- Sismanoglio General Hospital (GR)
- Simanogleio-Amalia Fleming General Hospital (GR)
- Corresponding author
- Feretzakis, Georgios
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2024-11-21
- Volume
- 110
- Issue
- 4
- Pages
- e1252-e1260
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC11913100
- OpenAlex
- W4404554530
- Cited by
- 19
- References
- 30
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 3
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Hellenic Academic Libraries Link
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- growth hormone therapy, chronic heart failure, left ventricular ejection fraction, peak oxygen uptake, NYHA functional class, mortality, ischemic cardiomyopathy, neurohormonal activation, exercise capacity
- MeSH terms
- Chronic Disease, Heart Failure, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Human Growth Hormone
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