Clinical Research Group Cardiomyopathy

Clinical Research

Prof. Dr. Karl Josef Osterziel

Congestive heart failure (CHF) is the common clinical endstage of most cardiac diseases. The incidence of CHF is constantly increasing despite of tremendous progress in medical therapy. Over the last decades the incidence is estimated at 1-3/1000. This means that there are more than 100 000 patients with newly diagnosed CHF each year in Germany alone. Dilated cardiomyopathy (DCM) is the second most important cause of CHF. Despite of optimal medical therapy there is still significant difficulty in preventing a deterioration of the patient's clinical situation. Therefore, newly therapeutic approaches are necessary.

Experimental studies and different case reports, gave support to the hypothesis that therapy with human recombinant growth hormon (hGH) would improve the clinical situation as well as the haemodynamic situation of patients with DCM. The increase in myocardial wall thickness and the reduction in left ventricular systolic wall pressure under hGH therapy may retard the progression of the disease. Other possible effects of hGH are an additional peripheral vasodilatation, a reduction of apoptosis of myocytes and an increase of contractility due to the altered cross-bridge kinetics of myocyte sarcomers. Therefore, we investigated in a pilot study (including 50 patients with DCM) alterations of myocardial mass and of LV wall stress. All patients were randomly and double-blind treated with hGH/placebo. Despite no clinical improvement of CHF was observed, a significant increase in myocardial mass and a significant reduction in left ventricular-wall stress could be shown. The increase of myocardial mass correlated with an increase of insulin like growth factor 1 ( IGF-1).