HFpEF and HFrEF Display Different Phenotypes as Assessed by IGF-1 and IGFBP-1

BackgroundAnabolic 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 ResultsIn 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.ConclusionHFpEF 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.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
insulin-like growth factor 1
insulin-like growth factor binding protein 1
heart failure with preserved ejection fraction
biomarker

Hage, CamillaKarolinska Institutet (författare)
Benson, LinaKarolinska Institutet (författare)
Zabarovskaja, Stanislava (författare)
Andreasson, AnnaKarolinska Institutet,Stockholms universitet,Stressforskningsinstitutet,Karolinska institutet, Sweden(Swepub:su)anan6088 (författare)
Donal, Erwan (författare)
Daubert, Jean-Claude (författare)
Linde, CeciliaKarolinska Institutet (författare)
Brismar, KerstinKarolinska Institutet (författare)
Lund, Lars H.Karolinska Institutet (författare)
Karolinska InstitutetStressforskningsinstitutet (creator_code:org_t)

Ingår i:Journal of Cardiac Failure: Elsevier BV23:4, s. 293-3031071-91641532-8414

Av författaren/redakt...: Ljung Faxén, Ulr ...; Hage, Camilla; Benson, Lina; Zabarovskaja, St ...; Andreasson, Anna; Donal, Erwan; visa fler...; Daubert, Jean-Cl ...; Linde, Cecilia; Brismar, Kerstin; Lund, Lars H.; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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