Although nutrition has gotten a lot of press for helping people gain weight, little was known about the link between heart failure and growth factors. At 3 visits: before discharge from neonatal intervention with the establishment of stable pulmonary blood flow, immediately before superior cavopulmonary connection, and before discharge after superior cavopulmonary connection. For a study, the researchers sought to conduct a prospective observational pilot study  to assess the relationship between heart failure, as measured by brain natriuretic peptide (BNP), and growth factors (insulin-like growth factor 1 [IGF-1] and insulin-like growth factor-binding protein 3).  At each visit, the relationship between BNP and growth factors was examined using Spearman pairwise correlations, and the relationship was modelled using a linear mixed-effects model over time. Given the exploratory character of the study, correlations with a p<0.10 were deemed worthy of further investigation. There were 38 infants in the research (66% male, 68% hypoplastic left heart syndrome). BNP levels were high at the start of the study and gradually reduced (287 pg/dl [interquartile range 147 to 794], 85 pg/dl [52 to 183], and 90 pg/dl [70 to 138]). At each visit, the median IGF-1 Z score was less than 0 but gradually climbed (−0.9 [interquartile range −1.1 to 0.1], −0.7 [−1.2 to 0.1], and −0.5 [−1.2 to 0]). BNP and IGF-1 at visit 1 (r=−0.40, p=0.097), BNP and IGF-1 and insulin-like growth factor-binding protein 3 at visit 2 (r=−0.33, p=0.080 and r=−0.33, p=0.085, respectively), and BNP and IGF-1 Z score at visit 3 (r=−0.42, p=0.049) all had inverse relationships. Between visits 1 and 3 (p=0.046) and visits 2 and 3 (p=0.048), significant correlations between BNP and IGF-1 were discovered. Finally, this pilot investigation found an inverse relationship between BNP and growth factors, implying that the heart failure condition associated with this physiology might just have a mechanistic role in stunted growth.