{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:27:13Z","timestamp":1789457233515,"version":"build-2803163510"},"reference-count":30,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018996","name":"Hellenic Academic Libraries Link","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018996","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Guideline-directed medical therapy of heart failure (HF) primarily targets neurohormonal activation. However, GH has emerged as a potential treatment for the multiple hormonal deficiency syndrome, which is associated with worse outcomes in HF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study evaluates the efficacy and safety of GH therapy in HF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Sources<\/jats:title>\n                  <jats:p>A systematic search was conducted in PubMed, Cochrane Library, and ClinicalTrials.gov, according to PRISMA guidelines<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Selection<\/jats:title>\n                  <jats:p>Randomized, placebo-controlled trials studying GH therapy in adult HF patients were included. Of the 1184 initially identified records, 17 studies (1.4%) met the inclusion criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data extraction<\/jats:title>\n                  <jats:p>Two independent authors conducted the search, with any disagreements resolved by a third author. Study quality was assessed using predefined criteria, including randomization, blinding, and the presence of a placebo group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Synthesis<\/jats:title>\n                  <jats:p>A random-effects model was applied due to heterogeneity across studies. GH therapy significantly improved left ventricular ejection fraction (+3.34%; 95% CI, 1.09-5.59; P = .0037), peak oxygen consumption (+2.84\u2005mL\/kg\/min; 95% CI, 1.32-4.36; P = .0002), and New York Heart Association class (\u22120.44; 95% CI, \u22120.08 to \u22120.81; P = .023). GH therapy also reduced the composite of death, worsening HF or ventricular tachycardia by 41% (RR = .59; 95% CI, 0.39-0.90; P = .013). Subgroup analyses indicated that patients with ischemic cardiomyopathy, baseline ejection fraction \u226530%, and longer treatment duration experienced greater benefits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>GH therapy demonstrated improvements in cardiac function, exercise capacity, and HF symptoms, along with a statistically significant trend toward improvements in hard endpoints. Event-driven trials are needed to validate these findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae814","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:27:11Z","timestamp":1732148831000},"page":"e1252-e1260","source":"Crossref","is-referenced-by-count":18,"title":["GH Therapy in Chronic Heart Failure: A Systematic Review and Meta-analysis of Randomized Controlled Trials"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0420-7327","authenticated-orcid":false,"given":"Nikolaos","family":"Theodorakis","sequence":"first","affiliation":[{"name":"Department of Cardiology & Heart Failure Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital , Melissia 15127 ,","place":["Greece"]},{"name":"School of Medicine, National and Kapodistrian University of Athens , Athens 11527 ,","place":["Greece"]},{"name":"School of Science and Technology, Hellenic Open University , Patras 26335 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3597-1187","authenticated-orcid":false,"given":"Georgios","family":"Feretzakis","sequence":"additional","affiliation":[{"name":"School of Science and Technology, Hellenic Open University , Patras 26335 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalini","family":"Kreouzi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine & 65+ Clinic, Sismanogleio-Amalia Fleming General Hospital , Melissia 15127 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Anagnostou","sequence":"additional","affiliation":[{"name":"Department of Cardiology & Heart Failure Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital , Melissia 15127 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Hitas","sequence":"additional","affiliation":[{"name":"Department of Cardiology & Heart Failure Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital , Melissia 15127 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilios S","family":"Verykios","sequence":"additional","affiliation":[{"name":"School of Science and Technology, Hellenic Open University , Patras 26335 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"Department of Cardiology & Heart Failure Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital , Melissia 15127 ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"2025031717093200200_dgae814-B1","doi-asserted-by":"publisher","first-page":"S1109-9666(24)00177-5","DOI":"10.1016\/j.hjc.2024.08.009","article-title":"Nationwide mortality trends from 2001 to 2020 in Greece: health policy implications under the scope of aging societies","author":"Nikolaou","year":"2024","journal-title":"Hellenic J Cardiol"},{"issue":"1","key":"2025031717093200200_dgae814-B2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/nrcardio.2016.163","article-title":"Neurohormonal activation in heart failure with reduced ejection fraction","volume":"14","author":"Hartupee","year":"2017","journal-title":"Nat Rev Cardiol"},{"issue":"15","key":"2025031717093200200_dgae814-B3","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1093\/eurjpc\/zwab020","article-title":"Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. 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