Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Acyl ghrelin increases cardiac output while preserving right ventricular-pulmonary arterial coupling in heart failure

Erhardsson, Mikael ; Faxén, Ulrika L. ; Venkateshvaran, Ashwin LU orcid ; Hage, Camilla ; Pironti, Gianluigi ; Thorvaldsen, Tonje ; Webb, Dominic Luc ; Hellström, Per M. ; Andersson, Daniel C. and Ståhlberg, Marcus , et al. (2024) In ESC Heart Failure 11(1). p.601-605
Abstract

Aim: Acyl ghrelin increases cardiac output (CO) in heart failure with reduced ejection fraction (HFrEF). This could impair the right ventricular-pulmonary arterial coupling (RVPAC), both through an increased venous return and right ventricular afterload. We aim to investigate if acyl ghrelin increases CO with or without worsening the right-sided haemodynamics in HFrEF assessed by RVPAC. Methods and results: The Karolinska Acyl ghrelin Trial was a randomized double-blind placebo-controlled trial of acyl ghrelin versus placebo (120-min intravenous infusion) in HFrEF. RVPAC was assessed echocardiographically at baseline and 120 min. ANOVA was used for difference in change between acyl ghrelin versus placebo, adjusted for baseline values.... (More)

Aim: Acyl ghrelin increases cardiac output (CO) in heart failure with reduced ejection fraction (HFrEF). This could impair the right ventricular-pulmonary arterial coupling (RVPAC), both through an increased venous return and right ventricular afterload. We aim to investigate if acyl ghrelin increases CO with or without worsening the right-sided haemodynamics in HFrEF assessed by RVPAC. Methods and results: The Karolinska Acyl ghrelin Trial was a randomized double-blind placebo-controlled trial of acyl ghrelin versus placebo (120-min intravenous infusion) in HFrEF. RVPAC was assessed echocardiographically at baseline and 120 min. ANOVA was used for difference in change between acyl ghrelin versus placebo, adjusted for baseline values. Of the 30 randomized patients, 22 had available RVPAC (acyl ghrelin n = 12, placebo n = 10). Despite a 15% increase in CO in the acyl ghrelin group (from 4.0 (3.5–4.6) to 4.6 (3.9–6.1) L/min, P = 0.003), RVPAC remained unchanged; 5.9 (5.3–7.6) to 6.3 (4.8–7.5) mm·(m/s)−1, P = 0.372, while RVPAC was reduced in the placebo group, 5.2 (4.3–6.4) to 4.8 (4.2–5.8) mm·(m/s)−1, P = 0.035. Comparing change between groups, CO increased in the acyl ghrelin group versus placebo (P = 0.036) while RVPAC and the right ventricular pressure gradient remained unchanged. Conclusion: Treatment with acyl ghrelin increases CO while preserving or even improving RVPAC in HFrEF, possibly due to increased contractility, reduced PVR and/or reduced left sided filling pressures. These potential effects strengthen the role of acyl ghrelin therapy in HFrEF with right ventricular failure.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acyl ghrelin, Heart failure, Inotrope
in
ESC Heart Failure
volume
11
issue
1
pages
5 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85178196889
  • pmid:38030138
ISSN
2055-5822
DOI
10.1002/ehf2.14580
language
English
LU publication?
yes
id
c7b58bae-cf44-4a5c-b3bc-69aa1646f6f1
date added to LUP
2024-01-08 09:35:42
date last changed
2024-12-18 06:06:05
@article{c7b58bae-cf44-4a5c-b3bc-69aa1646f6f1,
  abstract     = {{<p>Aim: Acyl ghrelin increases cardiac output (CO) in heart failure with reduced ejection fraction (HFrEF). This could impair the right ventricular-pulmonary arterial coupling (RVPAC), both through an increased venous return and right ventricular afterload. We aim to investigate if acyl ghrelin increases CO with or without worsening the right-sided haemodynamics in HFrEF assessed by RVPAC. Methods and results: The Karolinska Acyl ghrelin Trial was a randomized double-blind placebo-controlled trial of acyl ghrelin versus placebo (120-min intravenous infusion) in HFrEF. RVPAC was assessed echocardiographically at baseline and 120 min. ANOVA was used for difference in change between acyl ghrelin versus placebo, adjusted for baseline values. Of the 30 randomized patients, 22 had available RVPAC (acyl ghrelin n = 12, placebo n = 10). Despite a 15% increase in CO in the acyl ghrelin group (from 4.0 (3.5–4.6) to 4.6 (3.9–6.1) L/min, P = 0.003), RVPAC remained unchanged; 5.9 (5.3–7.6) to 6.3 (4.8–7.5) mm·(m/s)<sup>−1</sup>, P = 0.372, while RVPAC was reduced in the placebo group, 5.2 (4.3–6.4) to 4.8 (4.2–5.8) mm·(m/s)<sup>−1</sup>, P = 0.035. Comparing change between groups, CO increased in the acyl ghrelin group versus placebo (P = 0.036) while RVPAC and the right ventricular pressure gradient remained unchanged. Conclusion: Treatment with acyl ghrelin increases CO while preserving or even improving RVPAC in HFrEF, possibly due to increased contractility, reduced PVR and/or reduced left sided filling pressures. These potential effects strengthen the role of acyl ghrelin therapy in HFrEF with right ventricular failure.</p>}},
  author       = {{Erhardsson, Mikael and Faxén, Ulrika L. and Venkateshvaran, Ashwin and Hage, Camilla and Pironti, Gianluigi and Thorvaldsen, Tonje and Webb, Dominic Luc and Hellström, Per M. and Andersson, Daniel C. and Ståhlberg, Marcus and Lund, Lars H}},
  issn         = {{2055-5822}},
  keywords     = {{Acyl ghrelin; Heart failure; Inotrope}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{601--605}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{ESC Heart Failure}},
  title        = {{Acyl ghrelin increases cardiac output while preserving right ventricular-pulmonary arterial coupling in heart failure}},
  url          = {{http://dx.doi.org/10.1002/ehf2.14580}},
  doi          = {{10.1002/ehf2.14580}},
  volume       = {{11}},
  year         = {{2024}},
}