Ulrika Ljung Faxén1, Camilla Hage2, Lina Benson3, Stanislava Zabarovskaja2, Anna Andreasson4, Erwan Donal5, Jean-Claude Daubert5, Cecilia Linde2, Kerstin Brismar6, Lars H Lund2. 1. Department of Anesthesia and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Stockholm, Karolinska Institutet, Sweden. Electronic address: ulrikaljungfaxen@gmail.com. 2. Department of Medicine, Stockholm, Karolinska Institutet, Sweden; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. 3. Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden. 4. Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden. 5. Département de Cardiologie & CIC-IT U 804, Centre Hospitalier Universitaire de Rennes, France. 6. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.
Abstract
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.
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.
Authors: Cecilia Castro-Diehl; Rebecca J Song; Douglas B Sawyer; Kai C Wollert; Gary F Mitchell; Susan Cheng; Ramachandran S Vasan; Vanessa Xanthakis Journal: Int J Cardiol Date: 2021-01-07 Impact factor: 4.164
Authors: Roberta D'Assante; Michele Arcopinto; Giuseppe Rengo; Andrea Salzano; Marion Walser; Giuseppina Gambino; Maria Gaia Monti; Leonardo Bencivenga; Alberto M Marra; David N Åberg; Carlo De Vincentiis; Andrea Ballotta; Eduardo Bossone; Jörgen Isgaard; Antonio Cittadini Journal: ESC Heart Fail Date: 2021-01-29
Authors: Dominika Klimczak-Tomaniak; Marie de Bakker; Elke Bouwens; K Martijn Akkerhuis; Sara Baart; Dimitris Rizopoulos; Henk Mouthaan; Jan van Ramshorst; Tjeerd Germans; Alina Constantinescu; Olivier Manintveld; Victor Umans; Eric Boersma; Isabella Kardys Journal: Sci Rep Date: 2022-02-18 Impact factor: 4.379