Nagaya Noritoshi, Moriya Junji, Yasumura Yoshio, Uematsu Masaaki, Ono Fumiaki, Shimizu Wataru, Ueno Kazuyuki, Kitakaze Masafumi, Miyatake Kunio, Kangawa Kenji
Department of Internal Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan.
Circulation. 2004 Dec 14;110(24):3674-9. doi: 10.1161/01.CIR.0000149746.62908.BB. Epub 2004 Nov 29.
Ghrelin is a novel growth hormone-releasing peptide that also induces vasodilation, inhibits sympathetic nerve activity, and stimulates feeding through growth hormone-independent mechanisms. We investigated the effects of ghrelin on left ventricular (LV) function, exercise capacity, and muscle wasting in patients with chronic heart failure (CHF).
Human synthetic ghrelin (2 microg/kg twice a day) was intravenously administered to 10 patients with CHF for 3 weeks. Echocardiography, cardiopulmonary exercise testing, dual x-ray absorptiometry, and blood sampling were performed before and after ghrelin therapy. A single administration of ghrelin elicited a marked increase in serum GH (25-fold). Three-week administration of ghrelin resulted in a significant decrease in plasma norepinephrine (1132+/-188 to 655+/-134 pg/mL; P<0.001). Ghrelin increased LV ejection fraction (27+/-2% to 31+/-2%; P<0.05) in association with an increase in LV mass and a decrease in LV end-systolic volume. Treatment with ghrelin increased peak workload and peak oxygen consumption during exercise. Ghrelin improved muscle wasting, as indicated by increases in muscle strength and lean body mass. These parameters remained unchanged in 8 patients with CHF who did not receive ghrelin therapy.
These preliminary results suggest that repeated administration of ghrelin improves LV function, exercise capacity, and muscle wasting in patients with CHF.
胃饥饿素是一种新型的生长激素释放肽，它还可诱导血管舒张、抑制交感神经活动，并通过不依赖生长激素的机制刺激进食。我们研究了胃饥饿素对慢性心力衰竭（CHF）患者左心室（LV）功能、运动能力和肌肉萎缩的影响。
对10例CHF患者静脉注射人合成胃饥饿素（2微克/千克，每日两次），持续3周。在胃饥饿素治疗前后进行超声心动图、心肺运动试验、双能X线吸收法和血液采样。单次注射胃饥饿素可使血清生长激素显著增加（25倍）。连续3周注射胃饥饿素导致血浆去甲肾上腺素显著降低（从1132±188皮克/毫升降至655±134皮克/毫升；P<0.001）。胃饥饿素增加了左心室射血分数（从27±2%增至31±2%；P<0.05），同时左心室质量增加，左心室收缩末期容积减小。胃饥饿素治疗增加了运动期间的峰值工作量和峰值耗氧量。胃饥饿素改善了肌肉萎缩，表现为肌肉力量和瘦体重增加。8例未接受胃饥饿素治疗的CHF患者的这些参数保持不变。
这些初步结果表明，重复注射胃饥饿素可改善CHF患者的左心室功能、运动能力和肌肉萎缩。
