Post-prandial acyl ghrelin infusion in heart failure patients increases gastric emptying rate
Abstract
Acyl ghrelin increases cardiac output (CO) and contractility in patients with heart failure with reduced ejection fraction (HFrEF). In healthy humans, acyl ghrelin increases gastric emptying rate (GER) and hunger, a potential add-on benefit for HFrEF patients suffering from cachexia with symptoms of delayed gastric emptying and loss of appetite. The aim of this study was to determine if post-prandial acyl ghrelin infusion increases GER and hunger in HFrEF patients compared to CO. HFrEF patients (n = 29) arrived fasted and received a 500-kcal breakfast followed by 1.5 g paracetamol. They next received placebo (vehicle, n = 15) or acyl ghrelin infusion (0.1 µg/kg/min, n = 14) for 120 min. Blood was tapped for plasma at 0, 30, 60, 120, and 150 min into the meal. Hunger scores and CO were recorded. Plasma paracetamol was measured to assess GER. Paracetamol concentration peaked at 30 min in 8 of 14 (57%) in the treatment group versus 1 of 15 (7%) in the placebo group (Mann-Whitney test, P = 0.004). Remaining patients peaked at later time points. The acyl ghrelin treatment group data was segregated into rapid (peak at 30 min, n = 8) and slow (peak > 30 min, n = 6) GER sub-groups. The rapid sub-group had an acyl ghrelin treatment effect on CO (one-way repeat measures, P < 0.001) and the highest median increase in hunger across all time points. Acyl ghrelin increases GER and in tandem with increasing CO. Effects on hunger are more difficult to resolve due to variability in…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 29 participants or records.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.