The Effect of Growth Hormone Release (GHR) on Coronary Artery Disease Patients who are not Suitable for Mechanical Revascularization

Abstract

Objective: We evaluated in our study the effects of Growth Hormon Release (GHR) which is claimed as a natural modulator of Growth Hormone (GH) secretion at pituitary level, on coronary artery disease patients who don't have the possibility of mechanical revascularization. Materials and Methods: 67 patients who don't have the chance of mechanical revascularization due to the results of angiographic analysis were included in the study. After the standardization of anti-ischemia treatment, patients were evaluated clinically for basal homodynamic data, life quality criteria, limits of exertional capacity, and Duke treadmill scores (DTS) and then for 12 weeks GHR was given to the first group (n:38) and placebo was given to the other group(n:36). At the end of 12 weeks besides all the hemodynamic parameters; evaluation of all the patients was repeated for life quality criteria, limits of exertional capacity and DTS. Results: Basal clinical demographic characteristics of two groups were similar (p>0.05). Although 41 % decrease in weekly nitrate consumption (p:0.01), 39% decrease in weekly angina pectoris attacks (p:0.01), an increase of 98 seconds (p:0.01) in the mean period to 1 mm ST depression in treadmill and 40 % improvement in DTS (p:0.02) were seen in GHR group, there was no statistically significant change in placebo group (p>0.05). Conclusion: We believe that added-on GHR therapy on standard anti-ischemia treatment protocol in patients who don't have the chance of mechanical revascularization may improve the quality of life.

Keywords

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Growth Hormone Release (GHR)'in Mekanik Revaskülarizasyon İmkanı Olmayan Koroner Arter Hastalıklı Vakalar Üzerindeki Etkisi

Öz

Amaç: Çalışmamızda hipofizer seviyede doğal Growth Hormone (GH) sekresyonuna yol açtığı iddia edilen Growth Hormon Release (GHR)'nin mekanik revaskülarizasyon imkanı olmayan iskemik kalp hastalıklı hastalar üzerindeki etkisi araştırıldı. Gereç ve Yöntemler: Çalışmaya anjiyografik analizler sonucu mekanik revaskülarizasyon imkanı olmayan toplam 67 hasta alındı. Hastaların anti-iskemik tedavileri standardize edildikten ve bazal hemodinamik verilerini de içeren klinik bilgileri, yaşam kalitesi ölçütleri, egzersizyonel kapasite sınırları ve treadmill risk skorları (Duke treadmil skoru) tespit edildikten sonra, 12 hafta süre ile bir grup hastaya (n: 38,) GHR; diğer bir grup hastaya ise (n:36) uygun plesebo verildi. On ikinci haftanın sonunda ise tüm hastaların hemodinamik parametreleri ile birlikte yaşam kalitesi ölçütleri, egzersiz kapasitesi sınırları ve treadmil risk skorları tekrar incelendi. Bulgular: Grupların bazal klinik demografik özellikleri benzerdi (p>0.05). Bununla birlikte, tedavi sonrası GHR grubunda haftalık nitrat kullanımında %41 oranında azalma (5.4±4.5 tb'den 3.2±4.5 tb'te, p:0.01), haftalık angina pektoris atağında %39 oranında azalma (5.1±2.6'ten 3.1±1.5'e, p:0.01), 1 mm ST segment depresyonuna kadar geçen ortalama sürede 98 saniye uzama (185 ±142'snden 283±155'snye, p:0.01) ve Duke treadmil skorunda%40 oranında düzelme (-8.8 ±7.8'den -5.3±3.9'a, p:0.02) görülmesine rağmen; plesebo grubunda istatistiksel açıdan anlamlı herhangi bir değişiklik izlenmedi (p>0,05). Sonuç: GHR'nin standart anti-iskemik tedavi protokolüne ilave edilmesiyle mekanik revaskülarizasyon imkanı olmayan hastalarda yaşam kalitesini düzeltebileceği kanaatine varıldı.

Anahtar Kelimeler

• Koroner arter hastalığı, growth hormone release, treadmil risk skoru

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