Effects of Hormonal Therapy in Patients with Heart Failure

Abstract

Chronic heart failure is a multi-etiological disorder with high prevalence and poor prognosis. Several hormonal deficits have been observed in a consistent proportion of patients with this disease. Among them, testosterone deficiency and growth hormone/ insulin-like growth factor-1 axes impairment are highly prevalent and have been associated with a poor prognosis. Several experimental papers have highlighted the positive influence of growth hormone and testosterone in the regulation of heart development and performance. Moreover, many clinical studies have been started to investigate the effect of the administration of these two hormones in heart failure patients; a greater benefit has been evidenced in patients with hormonal deficiencies, by restoring physiological levels with hormonal therapy. These findings are promising, and, although not unanimously, indicate that both testosterone and growth hormone therapy should be considered as adjunctive therapy in advanced heart failure patients. However, larger randomized trials with longer treatment duration are needed to fully elucidate the efficacy and safety of the “hormonal therapy” in this patient population.