Ghrelin, a 28-amino-acid peptide, is an endogenous ligand for the growth hormone secretogogue receptor(GHS-R). It has been shown that the expression and function of ghrelin and its receptor change in heart failure. In addition to promoting growth hormone secretion, ghrelin has direct positive inotropic effect on cardiomyocytes, inhibit the apoptosis of cardiomyocytes and ventricular remodeling, protect myocardium directly, improve the disturbed myocardial energy metabolism and cardiac function, and attenuate the development of cardiac cachexia. It is suggested that ghrelin may have potential effects on the treatment of heart failure.