- Heart failure is a serious condition that affects how well the heart can pump blood around the body.
- Treatment for heart failure involves lifestyle changes and the use of certain medications.
- A recent study tested the hormone acyl ghrelin in people with chronic heart failure.
- Acyl-ghrelin was found to be effective at increasing cardiac output, which could lead to more research into the benefits of this treatment.
Heart failure is a potentially dangerous condition in which the heart cannot pump enough blood around the body. One area of interest is finding drugs that effectively improve heart function.
A recently published study in the European Heart Journalinvestigated the use of the peptide hormone acyl ghrelin to improve cardiac output in people with heart failure.
Researchers found that acyl ghrelin increased cardiac output, or how the heart pumps, in participants without causing negative side effects such as low blood pressure or abnormal heart rhythms.
It can also lead to serious complications such as kidney damage or sudden cardiac arrest.
Heart failure affects over
For example, people with coronary artery disease, diabetes, or high blood pressure have a higher risk of heart failure. Lifestyle habits such as low physical activity or a diet high in sodium can also increase the risk.
Treatment for heart failure involves a combined approach, often involving medication and lifestyle changes.
dr Kulpreet Barn, cardiologist and medical director of the Advanced Heart Failure Program at the Deborah Heart and Lung Center, who was not involved in the current study, explained Medical news today:
“If left untreated, heart failure can be a fatal diagnosis. Depending on the stage of the disease, there are several treatment options. It usually starts with the patient [medication], lifestyle changes and controlling risk factors. If that doesn’t work, there are several devices to help the heart function as the patient gets sicker. Once patients reach end-stage heart failure, they require advanced heart failure therapies such as [a] left ventricular assist device LVAD (a mechanical heart pump) or a heart transplant.”
The researchers of this study note that there are drugs that increase the contractility of the heart muscle and increase cardiac output.
However, these drugs can have side effects and are often only used for a short time.
Researchers wanted to see if ghrelin, a hormone that stimulates appetite, could effectively improve cardiac output. The researchers used an activated form of ghrelin, acyl ghrelin.
Study author Prof. Lars H. Lund from the Faculty of Medicine at the Karolinska Institute in Solna, Sweden, explained that the aim of the study “[t]o To test whether a novel drug treatment, acyl-ghrelin, is safe and effective for heart failure patients and to test the mechanism of action in the laboratory.”
The study was a randomized, double-blind, placebo-controlled study in approximately thirty participants with heart failure and reduced ejection fraction.
The ejection fraction has to do with the amount of blood that the heart pumps into the body with each contraction. Researchers also studied the effects of acyl ghrelin in the heart muscle cells of mice to investigate the underlying mechanisms for acyl ghrelin’s effects.
The participants were divided into either the treatment group or the placebo group. The placebo group received an intravenous infusion of saline, while the intervention group received synthetic human acyl ghrelin.
The infusions took place over 2 hours. There was a large improvement in cardiac output in the intervention group. Researchers saw about a 28 percent increase in cardiac output with no side effects.
The participants did not suffer from low blood pressure, high heart rate, ischemia or abnormal heart rhythms. At the 2- to 5-day follow-up period, participants in the intervention group still saw a level of cardiac function that was better than their pre-treatment baseline.
By examining mouse heart muscle cells, the researchers were able to examine some of the underlying mechanisms of acyl ghrelin action.
While more research is needed, acyl ghrelin’s lack of side effects may have to do with a lack of calcium ion mobilization.
The use of acyl ghrelin appears promising as a potential treatment option for people with heart failure.
dr Robert Segal, founder of Manhattan Cardiology, board-certified cardiologist and fellow of the American College of Cardiology (FACC), not affiliated with the study, noted MNT:
“The observed clinical benefit of acylated (activated) ghrelin looks promising and based on the results there is reason for further clinical development. Treating heart failure due to reduced ejection fraction has always been a mystery in medicine and hopefully we can turn this devastating disease around.”
This study had several limitations, so further research is warranted. First, the study included a small number of participants and had a short follow-up period. Further research could therefore consist of larger samples with a longer follow-up period.
In addition, because the study was an endogenous peptide hormone and not a novel molecule or drug, no formal adverse event reporting was required. However, the researchers monitored the participants during and after the treatment.
The researchers note that their study did not determine the optimal dose of acyl ghrelin. The researchers also had certain limitations in assessing heart function, and there may have been some differences between the placebo and intervention groups.
Some of the study authors also reported potential conflicts of interest.
More research is also needed to understand the underlying mechanism for the improvements researchers have found in heart function.
Prof Lund stated that “[t]The present study provides a basis for later phase studies of ghrelin-like treatments.”
He also added that future research could include: “[a] larger clinical trial with longer duration of treatment to test whether this treatment can be effective with chronic use.”
dr Barn further commented that this “was a great early-stage study that is promising as there are positive improvements in heart function.”
“Hopefully this can lead to an improvement for patients with congestive heart failure. However, a larger randomized trial is needed to see if these surrogate endpoints translate into clinical outcomes such as reductions in mortality and hospitalizations.”
— dr Kulpreet barn