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HFpEF and HFrEF Display Different Phenotypes as Assessed by IGF-1 and IGFBP-1
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2017 (English)In: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 23, no 4, 293-303 p.Article in journal (Refereed) Published
Abstract [en]

Background

Anabolic drive is impaired in heart failure with reduced ejection fraction (HFrEF) but insufficiently studied in heart failure with preserved ejection fraction (HFpEF). Insulin-like growth factor 1 (IGF-1) mediates growth hormone effects and IGF binding protein 1 (IGFBP-1) regulates IGF-1 activity. We tested the hypothesis that HFpEF and HFrEF are similar with regard to IGF-1 and IGFBP-1.

Methods and Results

In patients with HFpEF (n = 79), HFrEF (n = 85), and controls (n = 136), we analyzed serum IGF-1 and IGFBP-1 concentrations, correlations, and associations with outcome. Age-standardized scores of IGF-1 were higher in HFpEF, median arbitrary units (interquartile range); 1.21 (0.57–1.96) vs HFrEF, 0.09 (-1.40–1.62), and controls, 0.22 (-0.47-0.96), P overall <.001. IGFBP-1 was increased in HFpEF, 48 (28–79), and HFrEF, 65 (29–101), vs controls, 27(14–35) µg/L, P overall <.001. These patterns persisted after adjusting for metabolic and HF severity confounders. IGF-1 was associated with outcomes in HFrEF, hazard ratio per natural logarithmic increase in IGF-1 SD score 0.51 (95% confidence interval 0.32–0.82, P = .005), but not significantly in HFpEF. IGFBP-1 was not associated with outcomes in either HFpEF nor HFrEF.

Conclusion

HFpEF and HFrEF phenotypes were similar with regard to increased IGFBP-1 concentrations but differed regarding IGF-1 levels and prognostic role. HFrEF and HFpEF may display different impairment in anabolic drive.

Place, publisher, year, edition, pages
2017. Vol. 23, no 4, 293-303 p.
Keyword [en]
insulin-like growth factor 1, insulin-like growth factor binding protein 1, heart failure with preserved ejection fraction, biomarker
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:su:diva-134045DOI: 10.1016/j.cardfail.2016.06.008ISI: 000399064300006PubMedID: 27327968Local ID: P-3365OAI: oai:DiVA.org:su-134045DiVA: diva2:974973
Available from: 2016-09-28 Created: 2016-09-28 Last updated: 2017-05-29Bibliographically approved

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