The TOSCA Registry on heart failure, a Federiciana reality
The TOSCA Registry on heart failure, a Federiciana reality
A study by the team of Professor Antonio Cittadini, Full Professor of Internal Medicine atFederico II University and coordinator of the International Registry on Heart Failure T.O.S.CA., was published a few days ago in the prestigious European Journal of Preventive Cardiology, of the European Society of Cardiology.
Heart failure, despite therapeutic advances, remains an extremely high mortality disease, about 20% at 1 year and 50% at 5 years after a hospitalization episode, worse than many forms of cancer. In the last decade, more and more evidence has emerged in favor of an imbalance between catabolic and anabolic systems during disease progression, with a prevalence in favor of the former. Thus, it appears that heart failure is characterized not only by the activation of certain biological systems such as the adrenergic, renin-angiotensin-aldosterone, and cytokine systems, but by the deficiency of the major anabolic systems, including the somatotropic axis, adrenal axis, gonadal axis, thyroid axis, and insulin axis. For this reason, many authors consider chronic heart failure to be a syndrome of multiple hormonal and metabolic deficits.
On these premises, the TOSCA Registry was implemented to better investigate the real clinical impact, prevalence, and therapeutic implications of the presence of these multiple hormonal deficits in heart failure. It is a multicenter observational registry, involving 19 Italian and foreign centers, and entirely coordinated by the University Federico II. About 500 patients were enrolled with an average follow-up of 3 years. The study for the first time demonstrated unequivocally in a large population, with a prospective design, that multiple hormonal deficits are common in heart failure and are independent predictors of mortality and hospitalization. These findings are extremely interesting not only from a pathophysiological point of view, but because of the relevant therapeutic implications. It would theoretically be possible to treat some of these anabolic deficits with hormone replacement therapy to improve disease progression. Professor Antonio Cittadini, the first Italian to be awarded a GGI (Grant for Growth Innovation in 2016), a European fund provided by the Merck foundation, is also working on this innovative hypothesis for a study currently underway on growth hormone (GH) therapy of heart failure associated with GH deficiency.
Written by Redazione c/o COINOR: redazionenews@unina.it | redazionesocial@unina.it