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Electrophysiologic Effects of Growth Hormone Post-Myocardial Infarction. Int J Mol Sci 2020; 21:ijms21030918. [PMID: 32019245 PMCID: PMC7037853 DOI: 10.3390/ijms21030918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/26/2020] [Accepted: 01/28/2020] [Indexed: 02/05/2023] Open
Abstract
Myocardial infarction remains a major health-related problem with significant acute and long-term consequences. Acute coronary occlusion results in marked electrophysiologic alterations that can induce ventricular tachyarrhythmias such as ventricular tachycardia or ventricular fibrillation, often heralding sudden cardiac death. During the infarct-healing stage, hemodynamic and structural changes can lead to left ventricular dilatation and dysfunction, whereas the accompanying fibrosis forms the substrate for re-entrant circuits that can sustain ventricular tachyarrhythmias. A substantial proportion of such patients present clinically with overt heart failure, a common disease-entity associated with high morbidity and mortality. Several lines of evidence point toward a key role of the growth hormone/insulin-like growth factor-1 axis in the pathophysiology of post-infarction structural and electrophysiologic remodeling. Based on this rationale, experimental studies in animal models have demonstrated attenuated dilatation and improved systolic function after growth hormone administration. In addition to ameliorating wall-stress and preserving the peri-infarct myocardium, antiarrhythmic actions were also evident after such treatment, but the precise underlying mechanisms remain poorly understood. The present article summarizes the acute and chronic actions of systemic and local growth hormone administration in the post-infarction setting, placing emphasis on the electrophysiologic effects. Experimental and clinical data are reviewed, and hypotheses on potential mechanisms of action are discussed. Such information may prove useful in formulating new research questions and designing new studies that are expected to increase the translational value of growth hormone therapy after acute myocardial infarction.
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Caicedo D, Díaz O, Devesa P, Devesa J. Growth Hormone (GH) and Cardiovascular System. Int J Mol Sci 2018; 19:ijms19010290. [PMID: 29346331 PMCID: PMC5796235 DOI: 10.3390/ijms19010290] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 01/02/2023] Open
Abstract
This review describes the positive effects of growth hormone (GH) on the cardiovascular system. We analyze why the vascular endothelium is a real internal secretion gland, whose inflammation is the first step for developing atherosclerosis, as well as the mechanisms by which GH acts on vessels improving oxidative stress imbalance and endothelial dysfunction. We also report how GH acts on coronary arterial disease and heart failure, and on peripheral arterial disease, inducing a neovascularization process that finally increases flow in ischemic tissues. We include some preliminary data from a trial in which GH or placebo is given to elderly people suffering from critical limb ischemia, showing some of the benefits of the hormone on plasma markers of inflammation, and the safety of GH administration during short periods of time, even in diabetic patients. We also analyze how Klotho is strongly related to GH, inducing, after being released from the damaged vascular endothelium, the pituitary secretion of GH, most likely to repair the injury in the ischemic tissues. We also show how GH can help during wound healing by increasing the blood flow and some neurotrophic and growth factors. In summary, we postulate that short-term GH administration could be useful to treat cardiovascular diseases.
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Affiliation(s)
- Diego Caicedo
- Department of Angiology and Vascular Surgery, Complejo Hospitalario Universitario de Pontevedra, 36701 Pontevedra, Spain.
| | - Oscar Díaz
- Department of Cardiology, Complejo Hospitalario Universitario de Pontevedra, 36701 Pontevedra, Spain.
| | - Pablo Devesa
- Research and Development, The Medical Center Foltra, 15886 Teo, Spain.
| | - Jesús Devesa
- Scientific Direction, The Medical Center Foltra, 15886 Teo, Spain.
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Kontonika M, Barka E, Roumpi M, La Rocca V, Lekkas P, Daskalopoulos EP, Vilaeti AD, Baltogiannis GG, Vlahos AP, Agathopoulos S, Kolettis TM. Prolonged intra-myocardial growth hormone administration ameliorates post-infarction electrophysiologic remodeling in rats. Growth Factors 2017; 35:1-11. [PMID: 28264596 DOI: 10.1080/08977194.2017.1297432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Experimental studies indicate improved ventricular function after treatment with growth hormone (GH) post-myocardial infarction, but its effect on arrhythmogenesis is unknown. Here, we assessed the medium-term electrophysiologic remodeling after intra-myocardial GH administration in (n = 33) rats. GH was released from an alginate scaffold, injected around the ischemic myocardium after coronary ligation. Two weeks thereafter, ventricular tachyarrhythmias were induced by programmed electrical stimulation. Monophasic action potentials were recorded from the infarct border, coupled with evaluation of electrical conduction and repolarization from a multi-electrode array. The arrhythmia score was lower in GH-treated rats than in alginate-treated rats or controls. The shape and the duration of the action potential at the infarct border were preserved, and repolarization-dispersion was attenuated after GH; moreover, voltage rise was higher and activation delay was shorter. GH normalized also right ventricular parameters. Intra-myocardial GH preserved electrical conduction and repolarization-dispersion at the infarct border and decreased the incidence of induced tachyarrhythmias in rats post-ligation. The long-term antiarrhythmic potential of GH merits further study.
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Affiliation(s)
- Marianthi Kontonika
- a Department of Cardiology , Medical School, University of Ioannina , Greece
- b Cardiovascular Research Institute , Ioannina , Greece
| | - Eleonora Barka
- b Cardiovascular Research Institute , Ioannina , Greece
- c Ceramics and Composites Laboratory, Department of Materials Science and Engineering , University of Ioannina , Ioannina , Greece
| | - Maria Roumpi
- b Cardiovascular Research Institute , Ioannina , Greece
- c Ceramics and Composites Laboratory, Department of Materials Science and Engineering , University of Ioannina , Ioannina , Greece
| | | | | | - Evangelos P Daskalopoulos
- b Cardiovascular Research Institute , Ioannina , Greece
- d Pole of Cardiovascular Research, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique , Brussels , Belgium
| | | | | | - Antonios P Vlahos
- b Cardiovascular Research Institute , Ioannina , Greece
- e Pediatric Cardiology, Department of Child Health , Medical School, University of Ioannina , Ioannina , Greece
| | - Simeon Agathopoulos
- b Cardiovascular Research Institute , Ioannina , Greece
- c Ceramics and Composites Laboratory, Department of Materials Science and Engineering , University of Ioannina , Ioannina , Greece
| | - Theofilos M Kolettis
- a Department of Cardiology , Medical School, University of Ioannina , Greece
- b Cardiovascular Research Institute , Ioannina , Greece
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Bagno LL, Kanashiro-Takeuchi RM, Suncion VY, Golpanian S, Karantalis V, Wolf A, Wang B, Premer C, Balkan W, Rodriguez J, Valdes D, Rosado M, Block NL, Goldstein P, Morales A, Cai RZ, Sha W, Schally AV, Hare JM. Growth hormone-releasing hormone agonists reduce myocardial infarct scar in swine with subacute ischemic cardiomyopathy. J Am Heart Assoc 2015; 4:jah3883. [PMID: 25827134 PMCID: PMC4579962 DOI: 10.1161/jaha.114.001464] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Growth hormone-releasing hormone agonists (GHRH-As) stimulate cardiac repair following myocardial infarction (MI) in rats through the activation of the GHRH signaling pathway within the heart. We tested the hypothesis that the administration of GHRH-As prevents ventricular remodeling in a swine subacute MI model. METHODS AND RESULTS Twelve female Yorkshire swine (25 to 30 kg) underwent transient occlusion of the left anterior descending coronary artery (MI). Two weeks post MI, swine were randomized to receive injections of either 30 μg/kg GHRH-A (MR-409) (GHRH-A group; n=6) or vehicle (placebo group; n=6). Cardiac magnetic resonance imaging and pressure-volume loops were obtained at multiple time points. Infarct, border, and remote (noninfarcted) zones were assessed for GHRH receptor by immunohistochemistry. Four weeks of GHRH-A treatment resulted in reduced scar mass (GHRH-A: -21.9 ± 6.42%; P=0.02; placebo: 10.9 ± 5.88%; P=0.25; 2-way ANOVA; P=0.003), and scar size (percentage of left ventricular mass) (GHRH-A: -38.38 ± 4.63; P=0.0002; placebo: -14.56 ± 6.92; P=0.16; 2-way ANOVA; P=0.02). This was accompanied by improved diastolic strain. Unlike in rats, this reduced infarct size in swine was not accompanied by improved cardiac function as measured by serial hemodynamic pressure-volume analysis. GHRH receptors were abundant in cardiac tissue, with a greater density in the border zone of the GHRH-A group compared with the placebo group. CONCLUSIONS Daily subcutaneous administration of GHRH-A is feasible and safe in a large animal model of subacute ischemic cardiomyopathy. Furthermore, GHRH-A therapy significantly reduced infarct size and improved diastolic strain, suggesting a local activation of the GHRH pathway leading to the reparative process.
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Affiliation(s)
- Luiza L Bagno
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Rosemeire M Kanashiro-Takeuchi
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.) Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL (R.M.K.T., C.P., J.M.H.)
| | - Viky Y Suncion
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Samuel Golpanian
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Vasileios Karantalis
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Ariel Wolf
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Bo Wang
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Courtney Premer
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.) Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL (R.M.K.T., C.P., J.M.H.)
| | - Wayne Balkan
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Jose Rodriguez
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - David Valdes
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Marcos Rosado
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Norman L Block
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | | | - Azorides Morales
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.)
| | - Ren-Zhi Cai
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | - Wei Sha
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | - Andrew V Schally
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | - Joshua M Hare
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.) Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL (R.M.K.T., C.P., J.M.H.)
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Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine 2015; 48:25-35. [PMID: 24972804 PMCID: PMC4328125 DOI: 10.1007/s12020-014-0327-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/04/2014] [Indexed: 01/06/2023]
Abstract
In this review, the importance of growth hormone (GH) for the maintenance of normal cardiac function in adult life is discussed. Physiological effects of GH and underlying mechanisms for interactions between GH and insulin-like growth factor I (IGF-I) and the cardiovascular system are covered as well as the cardiac dysfunction caused both by GH excess (acromegaly) and by GH deficiency in adult hypopituitary patients. In both acromegaly and adult GH deficiency, there is also increased cardiovascular morbidity and mortality possibly linked to aberrations in GH status. Finally, the status of the GH/IGF-I system in relation to heart failure and the potential of GH as a therapeutic tool in the treatment of heart failure are reviewed in this article.
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Affiliation(s)
- Jörgen Isgaard
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45, Göteborg, Sweden,
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Daskalopoulos EP, Vilaeti AD, Barka E, Mantzouratou P, Kouroupis D, Kontonika M, Tourmousoglou C, Papalois A, Pantos C, Blankesteijn WM, Agathopoulos S, Kolettis TM. Attenuation of post-infarction remodeling in rats by sustained myocardial growth hormone administration. Growth Factors 2015; 33:250-8. [PMID: 26290214 DOI: 10.3109/08977194.2015.1072527] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Prevention of left ventricular remodeling is an important therapeutic target post-myocardial infarction. Experimentally, treatment with growth hormone (GH) is beneficial, but sustained local administration has not been thoroughly investigated. We studied 58 rats (322 ± 4 g). GH was administered via a biomaterial-scaffold, following in vitro and in vivo evaluation of degradation and drug-release curves. Treatment consisted of intra-myocardial injection of saline or alginate-hydrogel, with or without GH, 10 min after permanent coronary artery ligation. Echocardiographic and histologic remodeling-indices were examined 3 weeks post-ligation, followed by immunohistochemical evaluation of angiogenesis, collagen, macrophages and myofibroblasts. GH-release completed at 3 days and alginate-degradation at ∼7 days. Alginate + GH consistently improved left ventricular end-diastolic and end-systolic diameters, ventricular sphericity, wall tension index and infarct-thickness. Microvascular-density and myofibroblast-count in the infarct and peri-infarct areas were higher after alginate + GH. Macrophage-count and collagen-content did not differ between groups. Early, sustained GH-administration enhances angiogenesis and myofibroblast-activation and ameliorates post-infarction remodeling.
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Affiliation(s)
- Evangelos P Daskalopoulos
- a Department of Pharmacology , Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht , The Netherlands
- b Cardiovascular Research Institute , Ioannina , Athens , Greece
| | - Agapi D Vilaeti
- b Cardiovascular Research Institute , Ioannina , Athens , Greece
| | - Eleonora Barka
- b Cardiovascular Research Institute , Ioannina , Athens , Greece
- c Ceramics and Composites Laboratory, Department of Materials Science and Engineering, University of Ioannina , Ioannina , Greece
| | - Polixeni Mantzouratou
- d Department of Pharmacology , Medical School, University of Athens , Athens , Greece
| | - Dimitrios Kouroupis
- e Department of Biomedical Research, Foundation for Research and Technology-Hellas , Institute of Molecular Biology and Biotechnology , Ioannina , Greece , and
| | | | | | - Apostolos Papalois
- b Cardiovascular Research Institute , Ioannina , Athens , Greece
- f Experimental Research Center ELPEN , Pikermi , Athens , Greece
| | - Constantinos Pantos
- d Department of Pharmacology , Medical School, University of Athens , Athens , Greece
| | - W Matthijs Blankesteijn
- a Department of Pharmacology , Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht , The Netherlands
| | - Simeon Agathopoulos
- c Ceramics and Composites Laboratory, Department of Materials Science and Engineering, University of Ioannina , Ioannina , Greece
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Gruson D, Alexopoulou O, Pasquet A, Cumps J, Ketelslegers JM, Maiter D. Impact of growth hormone (GH) treatment on circulating Nt-proBNP concentrations and on cardiac function in adult GH-deficient patients. Scandinavian Journal of Clinical and Laboratory Investigation 2012; 72:387-94. [DOI: 10.3109/00365513.2012.685887] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Agarwal M, Naghi J, Philip K, Phan A, Willix RD, Schwarz ER. Growth hormone and testosterone in heart failure therapy. Expert Opin Pharmacother 2010; 11:1835-44. [PMID: 20486829 DOI: 10.1517/14656566.2010.485615] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Heart failure is a progressive disease affecting millions of people worldwide. The disease carries a significantly high morbidity and mortality risk. There are multiple pharmaceutical options to decrease this risk and prolong survival; however, despite optimization of medical management, several patients still await heart transplant, the only definitive cure for heart failure. To slow the progression of disease preventing need for transplantation, improve clinical symptoms, and improve heart failure outcomes, there is a persistent need to discover new therapeutic strategies. Of interest, low growth hormone and testosterone levels have been associated with a worsening degree of heart failure. Many studies have begun to show a clinical improvement in heart failure symptoms when these levels are corrected with hormonal therapy. These findings, although mixed, are promising and indicate that both testosterone and growth hormone therapy should be considered as adjunctive therapy in advanced heart failure patients. AREAS COVERED IN THIS REVIEW This review discusses the physiology of both of these natural hormones, their therapeutic effects in heart failure and data from the published literature on studies using growth hormone or testosterone in patients with chronic heart failure. An extensive search of PubMed was conducted for topics on heart failure, growth hormone, insulin-like growth factor, testosterone, their physiology and pathophysiology, and trials in which they have been used as therapeutic interventions between 1989 and 2009. WHAT THE READER WILL GAIN The reader will gain an understanding of the intricate balance of both of these hormones in the disease state of heart failure. In addition, the trials conducted using these hormones in pharmacotherapy for heart failure are discussed along with proposed theories for interstudy variability. TAKE HOME MESSAGE Testosterone deficiency and growth hormone resistance are positively associated with a poor state of heart failure. Treatment of deficiency improves outcomes in heart failure; however, there is a significant paucity of data with regard to testosterone and heart failure as well as a significant amount of study variability with growth hormone and heart failure.
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Affiliation(s)
- Megha Agarwal
- Cedars Sinai Medical Center Los Angeles, Cedars Sinai Heart Institute, 8700 Beverly Boulevard, Suite 6215, Los Angeles, California 90048, USA
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Santos DPD, Okoshi K, Moreira VO, Seiva FRF, Almeida FLAD, Padovani CR, Carvalho RF, Okoshi MP, Cicogna AC, Castro AVB, Pai-Silva MD. Growth hormone attenuates skeletal muscle changes in experimental chronic heart failure. Growth Horm IGF Res 2010; 20:149-155. [PMID: 20060348 DOI: 10.1016/j.ghir.2009.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 11/20/2009] [Accepted: 11/30/2009] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study evaluated the effects of growth hormone (GH) on morphology and myogenic regulatory factors (MRF) gene expression in skeletal muscle of rats with ascending aortic stenosis (AAS) induced chronic heart failure. DESIGN Male 90-100g Wistar rats were subjected to thoracotomy. AAS was created by placing a stainless-steel clip on the ascending aorta. Twenty five weeks after surgery, rats were treated with daily subcutaneous injections of recombinant human GH (2mg/kg/day; AAS-GH group) or saline (AAS group) for 14 days. Sham-operated animals served as controls. Left ventricular (LV) function was assessed before and after treatment. IGF-1 serum levels were measured by ELISA. After anesthesia, soleus muscle was frozen in liquid nitrogen. Histological sections were stained with HE and picrosirius red to calculate muscle fiber cross-sectional area and collagen fractional area, respectively. MRF myogenin and MyoD expression was analyzed by reverse transcription PCR. RESULTS Body weight was similar between groups. AAS and AAS-GH groups presented dilated left atrium, left ventricular (LV) hypertrophy (LV mass index: Control 1.90+/-0.15; AAS 3.11+/-0.44; AAS-GH 2.94+/-0.47 g/kg; p<0.05 AAS and AAS-GH vs. Control), and reduced LV posterior wall shortening velocity. Soleus muscle fiber area was significantly lower in AAS than in Control and AAS-GH groups; there was no difference between AAS-GH and Control groups. Collagen fractional area was significantly higher in AAS than Control; AAS-GH did not differ from both Control and AAS groups. Serum IGF-1 levels decreased in AAS compared to Control. MyoD mRNA was significantly higher in AAS-GH than AAS; there was no difference between AAS-GH and Control groups. Myogenin mRNA levels were similar between groups. CONCLUSION In rats with aortic stenosis-induced heart failure, growth hormone administration increases MyoD gene expression above non-treated animal levels, preserves muscular trophism and attenuates interstitial fibrosis. These results suggest that growth hormone may have a potential role as an adjuvant therapy for chronic heart failure.
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Affiliation(s)
- Denis Pioli dos Santos
- Department of Morphology, Bioscience Institute, São Paulo State University, Botucatu, São Paulo, Brazil
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Long-Term Effects of Growth Hormone on Infarct Size and Left Ventricular Function in Sheep With Coronary Artery Occlusion. J Cardiovasc Pharmacol 2010; 55:255-61. [DOI: 10.1097/fjc.0b013e3181cf9190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moreira VO, Pereira CA, Silva MO, Felisbino SL, Cicogna AC, Okoshi K, Aragon FF, Padovani CR, Okoshi MP, Castro AVB. GROWTH HORMONE ATTENUATES MYOCARDIAL FIBROSIS IN RATS WITH CHRONIC PRESSURE OVERLOAD-INDUCED LEFT VENTRICULAR HYPERTROPHY. Clin Exp Pharmacol Physiol 2009; 36:325-30. [DOI: 10.1111/j.1440-1681.2008.05086.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Elaiopoulos DA, Kolettis TM. Antiarrhythmic actions of growth hormone during acute myocardial infarction. J Electrocardiol 2008; 42:298-9. [PMID: 19100564 DOI: 10.1016/j.jelectrocard.2008.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Indexed: 10/21/2022]
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Hatzistergos KE, Mitsi AC, Zachariou C, Skyrlas A, Kapatou E, Agelaki MG, Fotopoulos A, Kolettis TM, Malamou-Mitsi V. Randomised comparison of growth hormone versus IGF-1 on early post-myocardial infarction ventricular remodelling in rats. Growth Horm IGF Res 2008; 18:157-165. [PMID: 17889582 DOI: 10.1016/j.ghir.2007.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2007] [Revised: 07/23/2007] [Accepted: 08/13/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Growth hormone and insulin-like growth factor-1 participate in post-myocardial infarction healing, but their relative importance is unclear. We compared the treatment effects of these agents on left ventricular remodelling. DESIGN Wistar rats were randomised into a single dose of either growth hormone (0.5microg, n=29), or insulin-like growth factor-1 (0.5microg, n=27), delivered by direct intramyocardial punctures, and were compared with controls (n=30). Five minutes after treatment, myocardial infarction was generated by permanent ligation of the left coronary artery. Twenty-four hours post-ligation, serum levels of catecholamines were measured using radioimmunoassay and infarct size as well as infarct expansion index were calculated. The expression of genes related to extracellular matrix and angiogenesis was measured using polymerase chain reaction. RESULTS Infarct expansion index was lower in growth hormone-treated rats (0.28+/-0.03, p=0.007) and in insulin-like growth factor-1-treated rats (0.35+/-0.03, p=0.044) compared to controls (0.51+/-0.06). Infarct size was significantly (p=0.0076) lower in growth hormone-treated rats (32.2+/-2.0%) and marginally (p=0.094) lower in insulin-like growth factor-1-treated rats (36.2+/-2.3%) compared to controls (42.0+/-2.7%). Survival rates were comparable in the three groups. Epinephrine was lower in the growth hormone group (2.8+/-0.2microg/l) compared to either controls (5.0+/-0.6microg/l, p=0.007), or to insulin-like growth factor-1-treated rats (6.3+/-0.6microg/l, p=0.0001). Collagen I and III expression in the infarct zone was higher in the growth hormone group compared to either the insulin-like growth factor-1 group or to controls. CONCLUSIONS Both growth hormone and insulin-like-growth factor-1 decrease early infarct expansion, but growth hormone results in more favourable extracellular matrix remodelling and sympathetic activation.
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Affiliation(s)
- K E Hatzistergos
- Department of Pathology, University of Ioannina, 1 Stavrou Niarxou Avenue, 45110 Ioannina, Greece
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14
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Elaiopoulos DA, Tsalikakis DG, Agelaki MG, Baltogiannis GG, Mitsi AC, Fotiadis DI, Kolettis TM. Growth hormone decreases phase II ventricular tachyarrhythmias during acute myocardial infarction in rats. Clin Sci (Lond) 2007; 112:385-91. [PMID: 17094772 DOI: 10.1042/cs20060193] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
GH (growth hormone) administration during acute MI (myocardial infarction) ameliorates subsequent LV (left ventricular) dysfunction. In the present study, we examined the effects of such treatment on arrhythmogenesis. A total of 53 Wistar rats (218+/-17 g) were randomized into two groups receiving two intraperitoneal injections of either GH (2 international units/kg of body weight; n=26) or normal saline (n=27), given at 24 h and 30 min respectively, prior to MI, which was generated by left coronary artery ligation. A single-lead ECG was recorded for 24 h post-MI, using an implanted telemetry system. Episodes of VT (ventricular tachyarrhythmia) and VF (ventricular fibrillation) during the first hour (phase I) and the hours following (phase II) MI were analysed. Monophasic action potential was recorded from the lateral LV epicardium at baseline and 24 h post-MI, and APD90 (action duration at 90% of repolarization) was measured. Infarct size was calculated 24 h post-MI. Infarct size and phase I VT+VF did not differ significantly between groups, but phase II hourly duration of VT+VF episodes was 82.8+/-116.6 s/h in the control group and 18.3+/-41.2 s/h in the GH group (P=0.0027), resulting in a lower arrhythmic (P=0.016) and total (P=0.0018) mortality in GH-treated animals. Compared with baseline, APD90 was prolonged significantly 24 h post-MI in the control group, displaying an increased beat-to-beat variation, but remained unchanged in the GH group. We conclude that GH decreases phase II VTs during MI in the rat. This finding may have implications in cardiac repair strategies.
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15
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Mulumba M, Céméus C, Dumont L, du Souich P, Ong H, Marleau S. Recombinant bovine growth hormone-induced reduction of atrial natriuretic peptide is associated with improved left ventricular contractility and reverse remodeling in cardiomyopathic UM-X7.1 hamsters with congestive heart failure. Growth Horm IGF Res 2007; 17:96-103. [PMID: 17280860 DOI: 10.1016/j.ghir.2006.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2006] [Revised: 11/22/2006] [Accepted: 12/11/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the effect of short-term treatment with GH on left ventricular contractility and remodeling, after the development of heart failure in cardiomyopathic hamsters (CMH). DESIGN Two groups of 200-day-old UM-X7.1 CMH received daily subcutaneous injections of recombinant bovine (rb) GH (1mg/kg/day) or 0.9% NaCl for 40 days. Golden Syrian hamsters (GSH) were used as controls. At 240-day-old, the hamsters were randomly subjected to (i) assessment of left ventricular systolic function in a Langendorff perfused mode followed by the determination of the passive diastolic pressure-volume relationship and morphometric measurements; (ii) assessment of left ventricular mRNA expression of genes belonging to the fetal gene program including atrial (ANP) and brain (BNP) natriuretic peptides and cardiac myosin heavy chain isoforms and of the circulating levels of the natriuretic peptides. RESULTS Hearts from CMH were hypertrophied and dilated (p<0.05) compared to hearts from GSH, along with a approximately 10-fold increase in the circulating ANP and BNP levels. Left ventricular BNP and ANP mRNAs were elevated by 2- and 3-fold, respectively, compared to GSH. rbGH reduced both ANP mRNA and ANP circulating levels by 34% (p<0.01) but did not significantly modulate BNP levels. This effect was associated with a preserved systolic function and reverse remodeling as assessed by a leftward shift of the passive diastolic pressure-volume relationship indicating reduced ventricular dilatation. CONCLUSIONS The data show that a short-term administration of GH in the terminal phase of the disease confers cardioprotection by attenuating systolic dysfunction and by inducing beneficial reverse remodeling.
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Affiliation(s)
- Mukandila Mulumba
- Faculty of Pharmacy, Université de Montréal, Station Centre-Ville, Montréal, Que, Canada
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16
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Bocchi E, Moura L, Guimarães G, Conceição Souza GE, Ramires JAF. Beneficial effects of high doses of growth hormone in the introduction and optimization of medical treatment in decompensated congestive heart failure. Int J Cardiol 2006; 110:313-7. [PMID: 16099518 DOI: 10.1016/j.ijcard.2005.06.068] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2004] [Revised: 02/11/2005] [Accepted: 06/24/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Optimizing oral therapy in patients with unstable decompensated and/or dobutamine-dependent congestive heart failure (CHF) is a challenge. METHODS AND RESULTS We investigated the effects of high doses of recombinant human growth hormone (GH) in 6 patients with cardiac cachexia and unstable decompensated CHF (5 dobutamine-dependent), including its influence in the optimization of oral CHF treatment. Patients received 8 IU of subcutaneous GH per day for median 26 (range 61) days. GH improved the systolic systemic blood pressure (SSBP, in mm Hg) from median 85 (range 34) to 100 (20) (p<.01), and the left ventricular (LV) ejection fraction (in %) from median 23 (range 22) (pretreatment) to 28 (18) (posttreatment) and 38 (28) (later) (p<.007). The NYHA functional class improved from IV to I in 2 patients, from IV to II in 3, and from IV to II-III in one. All patients were discharged from the hospital. It was possible in the hospital to initiate and after discharge to optimize long-term CHF treatment from 37.5 to 50 mg of carvedilol in 5 patients and with higher doses of captopril (from 50 to 150 mg) in all patients. Three patients are alive after 67, 75, and 11 months of follow-up. The remaining 3 patients died from a pulmonary abscess at 9 months, septicemia at 21 months, and progressive heart failure due to unplanned withdrawal of carvedilol at 36 months. CONCLUSION The use of GH in patients with decompensated CHF and cardiac cachexia provided clinical stability without the need for inotropic drugs permitting introduction of nonpreviously tolerated drugs. This could represent a new option for optimizing long-term CHF therapy and discharging hospitalized patients who are dobutamine-dependent.
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Affiliation(s)
- Edimar Bocchi
- Heart Failure Clinics of the Clinical Cardiology Department, Heart Institute of the São Paulo University Medical School, Brazil.
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17
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Mitsi AC, Hatzistergos KE, Niokou D, Pappa L, Baltogiannis GG, Tsalikakis DG, Papalois A, Kyriakides ZS, Malamou-Mitsi V, Kolettis TM. Early, intracoronary growth hormone administration attenuates ventricular remodeling in a porcine model of myocardial infarction. Growth Horm IGF Res 2006; 16:93-100. [PMID: 16624608 DOI: 10.1016/j.ghir.2006.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Revised: 02/09/2006] [Accepted: 02/09/2006] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Ventricular remodeling is a common corollary of myocardial infarction. We hypothesized that this process may be attenuated by growth hormone, administered as a single high-dose, selectively in the infarct zone, early postmyocardial infarction. DESIGN In 35 pigs (29+/-4 kg), myocardial infarction was generated by inflation of an over-the-wire angioplasty balloon in the circumflex artery for 60 min and 5 further pigs were sham-operated. Ten minutes after reperfusion, the pigs were randomized (2:1) to either growth hormone (1 IU/kg) (n=23) or normal saline (n=12), delivered via the balloon catheter. All survivors were treated with captopril and were sacrificed 4 weeks after myocardial infarction. RESULTS Compared to controls, growth hormone-treated animals displayed lower heart weight (4.1+/-0.5 g/kg body weight, versus 3.4+/-0.4 g/kg, respectively, p=0.003) and dimensions (left ventricular short axis diameter 46+/-7 mm versus 37+/-6 mm, p=0.01; right ventricular short axis diameter 38+/-7 mm versus 30+/-5 mm p=0.001). Growth hormone increased wall thickness in the infarct (6.0+/-1.8 in controls versus 9.9+/-3.7 in treated animals, p=0.004) and non-infarct zones (10.6+/-1.8 in controls versus 15.5+/-3.8 in treated animals, p=0.0006) and produced higher (p<0.05) microvascular density in both zones. CONCLUSION Intracoronary administration of growth hormone attenuates left and right ventricular remodeling by inducing hypertrophy and by enhancing angiogenesis.
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Affiliation(s)
- A C Mitsi
- Department of Cardiology, University of Ioannina, 1 Stavrou Niarxou Avenue, 45110 Ioannina, Greece
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18
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Strömer H, Palmieri EA, De Groot MCH, Di Rella F, Leupold A, Horn M, Monti MG, Napoli R, Di Gianni A, Isgaard J, Saccà L, Neubauer S, Cittadini A. Growth hormone- and pressure overload-induced cardiac hypertrophy evoke different responses to ischemia-reperfusion and mechanical stretch. Growth Horm IGF Res 2006; 16:29-40. [PMID: 16271488 DOI: 10.1016/j.ghir.2005.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Revised: 09/05/2005] [Accepted: 09/06/2005] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare the molecular, histological, and functional characteristics of growth hormone (GH)- and pressure overload-induced cardiac hypertrophy, and their responses to ischemia-reperfusion and mechanical stretch. DESIGN Four groups of male Wistar rats were studied: aortic banding (n=24, AB) or sham (n=24, controls) for 10 weeks, and GH treatment (n=24; 3.5mg/kg/day, GH) or placebo (n=24, controls) for 4 weeks. At 13 weeks, the rats were randomly subjected to: (i) assessment of basal left ventricular mRNA expression of sarcoplasmic reticulum calcium-ATPase (SERCA-2), phospholamban (PLB), and Na(+)-Ca(2+) exchanger (NCX) and collagen volume fraction (CVF) (Protocol A, 8 rats in each group); (ii) left ventricular no-flow ischemia with simultaneous evaluation of intracellular Ca(2+) handling and ATP, phosphocreatine (PCr) and inorganic phosphate (Pi) content (Protocol B, 12 rats in each group); or (iii) left ventricular mechanical stretch for 40 min with assessment of tumor necrosis-alpha (TNF-alpha) mRNA (Protocol C, 4 rats in each group). Protocol B and C were carried out in a Langendorff apparatus. RESULTS In Protocol A, no difference was found as to myocardial mRNA content of Ca(2+) regulating proteins and CVF in GH animals vs controls. In contrast, in the AB group, myocardial mRNA expression of SERCA-2 and PLB was downregulated while that of NCX and CVF were increased vs. controls (p<0.05). In Protocol B, recovery of left ventricular function was significantly decreased in AB vs GH groups and controls and this was associated with 1.6-fold increase in intracellular Ca(2+) overload during reperfusion (p<0.05). Baseline ATP content was similar in the four study groups, whereas PCr and Pi was lower in AB vs GH rats and controls. However, the time courses of high-energy phosphate metabolic changes did not differ during ischemia and reperfusion in the four study groups. In Protocol C, no detectable TNF-alpha mRNA level was found in the left ventricular myocardium of GH treated rats and controls at baseline, while a modest expression was noted in AB animals. Mechanical stretch resulted in de novo myocardial TNF-alpha mRNA expression in GH group and controls, which was dramatically increased in AB animals ( approximately 5-fold above baseline, p<0.001). CONCLUSIONS The data show that cardiac hypertrophy activated by short-term GH treatment confers cardioprotection compared with pressure overload with regard to molecular and histological characteristics, and responses to ischemia-reperfusion and mechanical stretch.
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Affiliation(s)
- Hinrik Strömer
- Department of Medicine, Medizinische Universitätsklinik Würzburg, 97080 Würzburg, Germany
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Serose A, Salmon A, Fiszman MY, Fromes Y. Short-term treatment using insulin-like growth factor-1 (IGF-1) improves life expectancy of the delta-sarcoglycan deficient hamster. J Gene Med 2006; 8:1048-55. [PMID: 16779861 DOI: 10.1002/jgm.934] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The hamster strain CHF147 presents a progressive dilated cardiomyopathy (DCM) due to a large deletion of the delta-sarcoglycan gene that leads to heart failure. This cardiomyopathy induces premature death. We have previously shown that a short-term treatment using IGF-1 preserves cardiac structure and improves function of the CHF147 hamster. METHODS In the current study, we measured long-term effects of short-term treatment with recombinant human IGF-1 (rhIGF-1) in CHF147 hamsters. CHF147 hamsters (7-8 months old) were implanted under the skin with an osmotic pump filled either with saline or with recombinant human IGF-1 at a total dose of 25 microg. The osmotic pump allowed a continuous delivery of the protein for a mean duration of 19 days. RESULTS We observed a significant increase in overall survival, as well as preservation of cardiac function, in the rhIGF-1-treated group. At the time of death, hearts of treated animals did not present any macroscopical or histological differences compared to those of sham hamsters. These results show that rhIGF-1 treatment slows down the evolution of the DCM in the CHF147 hamster. Moreover, the low dose treatment did not increase IGF-1 serum levels. CONCLUSIONS This study is the first one reporting beneficial effects of IGF-1 treatment on survival of an animal model presenting DCM. Our results raise hopes for a new therapeutic approach of this pathology.
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Affiliation(s)
- Armelle Serose
- Institut de Myologie, Institut National de la Santé et de la Recherche Médicale, U582, Université Pierre et Marie Curie, AP HP, CHU Pitié-Salpêtrière, IFR 14, Paris, France
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20
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Tivesten A, Isgaard J. Cardiovascular and Respiratory Systems. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2005; 567:149-66. [PMID: 16370139 DOI: 10.1007/0-387-26274-1_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Asa Tivesten
- Research Center for Endocrinology and Metabolism, Department of Internal Medicine, Sahlgrenska Academy at the University of Göteborg, Sweden
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21
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Abstract
BACKGROUND Cardiovascular disease is a major cause of death in end-stage renal disease (ESRD). Since growth hormone is required for maintaining normal cardiac structure and function and as growth hormone has a salutary effect on cardiac remodeling in disease, we postulated that if cardiac resistance to growth hormone develops in chronic renal failure (CRF) this may predispose to the cardiomyopathy of uremia. We set out to test whether in CRF there is resistance to the cardiac action of growth hormone and whether this defect might be caused by altered growth hormone signaling. METHODS Growth hormone-deficient (dw/dw) rats and growth hormone-intact Sprague-Dawley rats underwent a subtotal nephrectomy or sham operation and pair feeding. RESULTS In dw/dw rats treated with growth hormone for 8 days there was a significant increase in insulin-like growth factor-1 (IGF-1) mRNA levels in controls but this response was attenuated in CRF. Next, growth hormone-stimulated Janus kinase-signal transducers and activators of transcription (JAK2-STAT5) signaling was studied 15 minutes after intravenous growth hormone in dw/dw and Sprague-Dawley rats. Growth hormone receptor, JAK2, STAT5a, and STAT5b protein levels were unaltered in CRF. Growth hormone-induced JAK2, growth hormone receptor (GHR), and STAT5 tyrosine phosphorylation was significantly depressed in CRF as was nuclear translocation of phosphorylated STAT5. When rats were treated with pharmacologic dose growth hormone, STAT5 phosphorylation increased similarly in CRF and control rats. CONCLUSION Uremic rats develop cardiac resistance to growth hormone caused at least, in part, by a postreceptor defect in growth hormone-induced signaling that is characterized by impaired phosphorylation and nuclear translocation of STAT5. These findings raise the question whether growth hormone resistance contributes to the cardiac changes of uremia.
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Affiliation(s)
- Zhilan Zheng
- Research Service, Veterans Affairs Palo Alto Health Care System and Department of Medicine, Stanford University, Palo Alto, California 94304, USA
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22
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Mitsi AC, Hatzistergos K, Baltogiannis GG, Kolettis TM. Early, selective growth hormone administration may ameliorate left ventricular remodeling after myocardial infarction. Med Hypotheses 2005; 64:582-5. [PMID: 15617872 DOI: 10.1016/j.mehy.2004.07.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Accepted: 07/18/2004] [Indexed: 11/20/2022]
Abstract
Left ventricular (LV) remodeling after myocardial infarction (MI) may lead to congestive heart failure, disability and death. It consists of expansion of the infarct zone and dilatation of the non-infarcted myocardium, causing shape distortion and ventricular enlargement. Experimental studies have shown that treatment with growth hormone (GH) stimulates cardiac repair, resulting in increased infarct zone collagen scar formation and possibly enhanced proteinosynthesis. These actions may ameliorate the process of LV remodeling. We hypothesize that these beneficial effects may be more prominent, if GH is delivered selectively in the infarct area, during the early phase of acute MI. Experimental and clinical studies are necessary to validate this hypothesis.
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Affiliation(s)
- A C Mitsi
- Department of Cardiology, University of Ioannina, 1 University Avenue, University Campus, 45110 Ioannina, Epirus, Greece
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Jayasankar V, Bish LT, Pirolli TJ, Berry MF, Burdick J, Woo YJ. Local myocardial overexpression of growth hormone attenuates postinfarction remodeling and preserves cardiac function. Ann Thorac Surg 2004; 77:2122-9; discussion 2129. [PMID: 15172279 DOI: 10.1016/j.athoracsur.2003.12.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2003] [Indexed: 11/25/2022]
Abstract
BACKGROUND Ventricular remodeling with chamber dilation and wall thinning is seen in postinfarction heart failure. Growth hormone induces myocardial hypertrophy when oversecreted. We hypothesized that localized myocardial hypertrophy induced by gene transfer of growth hormone could inhibit remodeling and preserve cardiac function after myocardial infarction. METHODS Rats underwent direct intramyocardial injection of adenovirus encoding either human growth hormone (n = 9) or empty null vector as control (n = 9) 3 weeks after ligation of the left anterior descending coronary artery. Analysis of the following was performed 3 weeks after delivery: hemodynamics, ventricular geometry, cardiomyocyte fiber size, and serum growth hormone levels. RESULTS The growth hormone group had significantly better systolic cardiac function as measured by maximum left ventricular pressure (73.6 +/- 6.9 mm Hg versus control 63.7 +/- 7.8 mm Hg, p < 0.05) and maximum dP/dt (2845 +/- 453 mm Hg/s versus 1949 +/- 605 mm Hg/s, p < 0.005), and diastolic function as measured by minimum dP/dt (-2520 +/- 402 mm Hg/s versus -1500 +/- 774 mm Hg/s, p < 0.01). Ventricular geometry was preserved in the growth hormone group (ventricular diameter 12.2 +/- 0.7 mm versus control 13.1 +/- 0.4 mm, p < 0.05; borderzone wall thickness 2.0 +/- 0.2 mm versus 1.5 +/- 0.1 mm, p < 0.001), and was associated with cardiomyocyte hypertrophy (6.09 +/- 0.63 microm versus 4.66 +/- 0.55 microm, p < 0.005). Local myocardial expression of growth hormone was confirmed, whereas serum levels were undetectable after 3 weeks. CONCLUSIONS Local myocardial overexpression of growth hormone after myocardial infarction resulted in cardiomyocyte hypertrophy, attenuated ventricular remodeling, and improved systolic and diastolic cardiac function. The induction of localized myocardial hypertrophy presents a novel therapeutic approach for the treatment of ischemic heart failure.
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Affiliation(s)
- Vasant Jayasankar
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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Cittadini A, Isgaard J, Monti MG, Casaburi C, Di Gianni A, Serpico R, Iaccarino G, Saccà L. Growth hormone prolongs survival in experimental postinfarction heart failure. J Am Coll Cardiol 2003; 41:2154-63. [PMID: 12821240 DOI: 10.1016/s0735-1097(03)00483-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We evaluated the effects of growth hormone (GH) on survival in experimental heart failure (HF). BACKGROUND Growth hormone has been beneficial in various models of experimental HF. Whether GH also affects HF progression and survival is not known. METHODS A total of 119 rats with moderate myocardial infarction were randomized to receive either GH (3.5 mg/kg every other day) or placebo for 28 days. Treatment was initiated one month after coronary ligation; the follow-up lasted 13 months. In the surviving animals, Doppler echocardiography and closed-chest Millar left ventricular (LV) catheterization were performed. Apoptosis, collagen volume fraction, and capillary density in the LV zone remote from infarction were measured. The early effects of GH on apoptosis were also assessed in a subgroup of eight infarcted rats, treated as specified earlier and euthanized at one month. RESULTS Survival rate was 68% in GH-treated rats and 48% in the placebo group (p = 0.0377). Growth hormone had no effect on myocardial architecture, systolic function, and sarcoplasmatic reticulum calcium ATPase-2 messenger ribonucleic acid. Growth hormone improved LV relaxation; this was associated with a 50% reduction in collagen volume fraction and a 27% increase in capillary density. Growth hormone reduced the apoptotic index by 50% at one month and by 33% at 13 months. CONCLUSIONS Growth hormone prolonged survival of rats with postinfarction HF. This effect was associated with marked attenuation of cardiomyocyte apoptosis and pathologic interstitial remodeling in the surviving myocardium and enhanced LV relaxation.
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Affiliation(s)
- Antonio Cittadini
- Department of Internal Medicine and Cardiovascular Sciences, University Federico II, Naples, Italy
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