In addition to the observed metabolic alterations resulting from chronic elevations in GH and IGF-1 concentrations which can lead to the development pro-apoptotic conditions in vivo [13,14], case studies have reported that a prolonged history of rhGH abuse can lead to the development of cardiomyopathy and heart failure [44,45], conditions which are associated with deregulated apoptosis [46]. The gene discussed is IGF1; the disease is heart failure.