Long-Term Efficacy and Safety of Growth Hormone Replacement Therapy in Chronic Heart Failure

Inclusion Criteria: * Chronic Heart Failure New York Heart Association functional class II to IV, secondary to ischemic or idiopathic cardiomyopathy * Age range 18-80 years * Stable medication for at least one month including beta-blockers that had to be started at least 5 months before entering the study * Left Ventricular ejection fraction 40% or less * Growth Hormone Deficiency (defined as a peak GH response to intravenous stimulation with GHRH + Arginine \< 9 ng/ml) * Written Informed consent Exclusion Criteria: * Acute proliferative or severe non-proliferative diabetic retinopathy * Active malignancy * Evidence of progression or recurrence of an underlying intracranial tumor * Unstable Angina or recent myocardial infarction * Serum Creatinine levels \> 2.5 mg/dl * Severe liver disease (Child-Pugh B-C)