The data from animal and @entity1 in-vivo studies suggest that cardiac function is dependent in part on the normal function of the GH/ @entity442 axis (growth hormone/insulin-like growth factor-1). The syndrome of @entity712 appears to be associated with a perturbation of the GH/ @entity442 axis. So far encouraging results from phase II clinical trials evaluating the effects of long-term growth hormone treatment in @entity1 with moderate to severe chronic @entity712 due to @entity384 have been published. In these studies growth hormone (i.e., DNA-derived recombinant @entity1 growth hormone) was not used alone but in addition to standard optimal therapy for @entity712 . The following rationale is the basis of this new approach for the treatment of chronic @entity712 due to @entity384 . According to Laplace's Law, cardiac wall stress(i.e., the force acting per unit of cross-sectional area of the ventricular wall) is directly related to intraventricular pressure and ventricular radius and inversely related to ventricular wall thickness. Cardiac (ventricular) wall stress if @entity384 (mainly because of the dilatation of the ventricles and to a minor extent because of the relative reduction in ventricular thickness). Growth hormone seems to be capable of increasing ventricular wall thickness in @entity384 , thus, reducing cardiac wall stress which in turn leads to an improvement in systolic cardiac performance. Recombinant @entity1 growth hormone as a pharmacologic treatment is not only an expensive but also risky therapeutic modality (e.g., potential risk of inducing @entity694 , @entity1778 , relapses of @entity1778 and @entity1221 ). Given these prerequisites and a receptivity for cost effectiveness and risk-benefit analyses, it seems as if subcutaneous recombinant @entity1 growth hormone-as an additional therapeutic substance in conjunction with one of the widely accepted drugs for end-stage chronic @entity712 due to @entity384 -e.g., angiotensin converting-enzyme inhibitors, diuretics, @entity3362 , @entity6838 , and beta-adrenergic receptor blockers ( @entity1405 ) could either become a bridge to transplantation (i.e., supporting @entity1 awaiting transplantation) or an alternative to the very expensive cardiac transplantation. There are three reasons for this hypothesis. First, the fact that end-state @entity384 along with @entity741 are the main indications for heart transplantation in adults; second, the worldwide small supply of @entity1 donor organs for heart transplantation; and, third, the urgent need to find alternative cost-effective and risk-beneficial therapeutic modalities.

[Therapy of XXXX with growth hormone].

@entity1 :: ('9606', 'Species') :: ['human', 'patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure', 'chronic heart failure', 'heart failure'] @entity3362 :: ('MESH:D009566', 'Chemical') :: ['nitrates'] @entity384 :: ('MESH:D002311', 'Disease') :: ['dilated cardiomyopathy', 'increased in dilated cardiomyopathy'] @entity442 :: ('3479', 'Gene') :: ['IGF-1'] @entity1221 :: ('MESH:D016543', 'Disease') :: ['central nervous system tumors'] @entity1405 :: ('MESH:C043211', 'Chemical') :: ['Carvedilol'] @entity6838 :: ('MESH:D004077', 'Chemical') :: ['digoxin'] @entity1778 :: ('MESH:D007938', 'Disease') :: ['de-novo leukemias', 'leukemias'] @entity741 :: ('MESH:D017202', 'Disease') :: ['ischemic heart disease'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colonic carcinoma']
@entity384 :: (MESH:D002311,Disease) :: ['terminal dilated cardiomyopathy']
