The growth hormone - insulinlike growth factor-1 axis at different phases of chronic heart failure development

Objective. To study the dynamics of serum growth hormone (GH), insulin-like growth factor-1 (IGF-1) and markers of
system infl ammation in patients with chronic heart failure (CHF) depending on different phases of heart failure development.
Design and methods. 53 men (age 47-75 years old) with coronary artery disease (CAD), hospitalized because of the CHF
decompensation, were included. The control group consists of 13 men (age 46-69 years old) with ischemic heart disease and
normal left ventricular ejection fraction (LVEF ≥ 60 %). Serum GH, IGF-1, NT pro-BNP and C-reactive protein (CRP) were
measured at baseline, when stabilization was achieved and every 6 month of follow-up. Results. In patients with ischemic
CHF, hospitalized due to the CHF decompensation, signifi cant increase of GH level was found, compared to control group
(1,23 and 0,22 mME/l, p < 0,01). This was accompanied by the decrease in the level of IGF-1 (222 and 415 ng/ml, p < 0,01).
This condition is known as resistance to GH. Improvement of patients' state is followed by the decrease in GH level with
preserved stable low level of IGF-1. The strong interrelation of GH and NT pro-BNP levels remained during follow-up: at
baseline (r = 0,59; p < 0,0001), when stabilization was achieved (r = 0,40; p < 0,0001) and every 6 month of follow-up (r = 0,43;
p < 0,0001). Serum CRP had no difference in patients with CHF compared to controls. However, CRP level signifi cantly
decreased over time: stabilization (p = 0,01) and in 6-month period (p = 0,004). Conclusions. 1) In patients with ischemic
CHF III-IV functional class GH level was associated with IGF-1 level and ranged within normal rates. GH level decreased
when stabilization was achieved, and did not change in 6 months compared to the level of GH at decompensation phase.
2) IGF-1 level in patients with ischemic CHF was decreased compared to patients with CAD and did not change in different
phases of heart failure. 3) CRP level was increased compared to patients with CAD and was decreased at stabilization, as
well as in 6-month period of follow-up. The strong interrelation of GH and CRP levels was shown.

chronic heart failure, growth hormone, insulin-like growth factor-1, C-reactive protein

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