The specific aim of this study is to restore plasma growth hormone levels, which are often deficient in normal elderly volunteers and patietns with congestive heart failure, to the levels found in younger adults. A dose, frequency and duration study. There is a decline in circulating GH levels with advancing age, which is accompanied by clinically significant sequelae. Another prevalent condition in the elderly also associated with decline in function is cogestive heart failure (CHF). Restoration of plasma GH levels has been showen to result in improved function both in the normal elderly (increaed bone mineral density and changes in body composition) and in patients with CHF (improved myocardial function). Replacement with GH results in unacceptable untoward side effects which can be entirely avoided with recombinant human growth hormone releasing factor. However, the optimal dose and mode of administration have not been established. Elderly individuals with a decrease in GH levels, as assessed by low IGF-1 levels, will be identified. They will receive an IV bolus infusion of rhGRF and then randomized into a daily or twice daily subcutaneous (s.c.) administration of rhGRF for 21 days. Elderly individuals with a diagnosis of CHF (New York Heart Association class II & III) will also undergo the same protocol as the normal elderly volunteers. All responses in the elderly will be compared to that of normal young volunteers. Young volunteers will not undergo the 21 days of treatment. The end point of this study is the evaluation of GH response follwoing 21 days of rhGRF treatment in the old volunteers and GH response to the single IV or s.c. administration of rhGRF in young volunteers. It is hoped that this study will establish the minimal dose and frequency required to restore GH levels, in the normal elderly and elderly patietns with CHF to those found in young individuals.
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