TY - JOUR
T1 - Ghrelin resistance occurs in severe heart failure and resolves after heart transplantation
AU - Lund, Lars H.
AU - Williams, Jill J.
AU - Freda, Pamela
AU - Lamanca, John J.
AU - Lejemtel, Thierry H.
AU - Mancini, Donna M.
PY - 2009/8
Y1 - 2009/8
N2 - AimsSevere heart failure (HF) is often associated with cachexia that reverses post-heart transplantation (HTx) with frequent development of obesity. Ghrelin is a novel appetite-stimulating hormone. The aim was to determine the role of ghrelin in regulating appetite, food intake, and body composition in HF and post-HTx.Methods and resultsWe measured serial ghrelin, hunger sensation, caloric intake, and body composition in 12 HF patients awaiting HTx, 12 patients 12.7 ± 8.6 months post-HTx, and 7 controls. Seven of 12 HF patients were followed for longitudinal analysis post-HTx. Body mass index was 23.1 ± 3.1 in HF and 31.5 ± 5.5 post-HTx (P < 0.001). Heart transplantation patients had gained 18.0 ± 7.7 kg since HTx. Ghrelin area under the curve between controlled meals (control: 186 ± 39; HF: 264 ± 71; HTx: 194 ± 47 ng min/mL, P < 0.007) was higher in HF, but test meal caloric intake (control: 1185 ± 650; HF: 391 ± 103; HTx: 831 ± 309 kcal, P < 0.008) was lower in HF. The longitudinal analysis confirmed these findings.ConclusionHeart failure may be associated with resistance to the appetite-stimulating effects of ghrelin, which may contribute to cachexia. Heart transplantation may be associated with resolution of ghrelin resistance, which may contribute to weight gain. These findings are preliminary and should be confirmed in larger trials.
AB - AimsSevere heart failure (HF) is often associated with cachexia that reverses post-heart transplantation (HTx) with frequent development of obesity. Ghrelin is a novel appetite-stimulating hormone. The aim was to determine the role of ghrelin in regulating appetite, food intake, and body composition in HF and post-HTx.Methods and resultsWe measured serial ghrelin, hunger sensation, caloric intake, and body composition in 12 HF patients awaiting HTx, 12 patients 12.7 ± 8.6 months post-HTx, and 7 controls. Seven of 12 HF patients were followed for longitudinal analysis post-HTx. Body mass index was 23.1 ± 3.1 in HF and 31.5 ± 5.5 post-HTx (P < 0.001). Heart transplantation patients had gained 18.0 ± 7.7 kg since HTx. Ghrelin area under the curve between controlled meals (control: 186 ± 39; HF: 264 ± 71; HTx: 194 ± 47 ng min/mL, P < 0.007) was higher in HF, but test meal caloric intake (control: 1185 ± 650; HF: 391 ± 103; HTx: 831 ± 309 kcal, P < 0.008) was lower in HF. The longitudinal analysis confirmed these findings.ConclusionHeart failure may be associated with resistance to the appetite-stimulating effects of ghrelin, which may contribute to cachexia. Heart transplantation may be associated with resolution of ghrelin resistance, which may contribute to weight gain. These findings are preliminary and should be confirmed in larger trials.
KW - Appetite
KW - Cachexia
KW - Ghrelin
KW - Heart failure
KW - Heart transplantation
KW - Weight gain
UR - http://www.scopus.com/inward/record.url?scp=67749084358&partnerID=8YFLogxK
U2 - 10.1093/eurjhf/hfp088
DO - 10.1093/eurjhf/hfp088
M3 - Article
C2 - 19556330
AN - SCOPUS:67749084358
SN - 1388-9842
VL - 11
SP - 789
EP - 794
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 8
ER -