Treatment of the lOw IGF-1 Syndrome aSsociated With Chronic Heart fAilure: A Randomized, Placebo-Controlled, Double-Blind Study.

Phase 2 Study of Growth Hormone Administration in Patients With Chronic Heart Failure and Low IGF-1 Levels

The objective of the study is to determine whether treatment of the low IGF-1 syndrome in patients with CHF is able to modify some functional parameters, recognized as valid surrogate end-points of CHF progression.

Inclusion Criteria:

• patients of either sex affected by CHF NYHA class II-III, secondary to ischemic or idiopathic dilated cardiomyopathy
• age range 30-80 years
• stable medications for at least two months prior to randomization, including ACE inhibitors or AT1 antagonists and beta-blockers (unless untolerated).
• LV ejection fraction 40% or less
• Peak VO2 consumption during a CPET ≤ 16 ml/kg/min.
• LV end-diastolic dimension 55 mm or more
• low IGF-1 levels and a satisfactory response to an IGF-1 generation test
• informed consent

Exclusion Criteria:

• haemodynamic clinically significant primary valvular disease or significant congenital heart disease
• acute pericarditis/myocarditis
• inability to perform a bicycle exercise test
• Poorly controlled diabetes mellitus (HbA1c >8.5)
• active proliferative or severe non-proliferative diabetic retinopathy
• active and/or history of malignancy
• evidence of progression or recurrence of an underlying intracranial tumor
• unstable angina or recent myocardial infarction (less than 5 months)
• severe liver disease
• serum creatinine levels >2.5 mg/dl
• Inability to cooperate or administer the study drug
• Patients participating in any other clinical study, within 30 days prior to screening visit and/or during this particular study period