title: Increased level of pericardial insulin-like growth factor-1 in patients with left ventricular dysfunction and advanced heart failure.
abstract: OBJECTIVE
  To test the hypothesis that the cardiac insulin-like growth factor-1 (IGF-1) system is up-regulated in the failing heart, we measured the pericardial (cardiac) and plasma (circulating) IGF-1 levels in coronary artery disease patients.
  
  
  BACKGROUND
  Local IGF-1 systems are regulated differently from the systemic IGF-1 system. The cardiac IGF-1 system is up-regulated by the increased left ventricular (LV) wall stress. However, it remains unknown how this system is affected in LV dysfunction and heart failure.
  
  
  METHODS
  We measured the plasma and pericardial fluid levels of IGF-1 and brain natriuretic peptide (BNP) in 87 coronary artery disease patients undergoing cardiac surgery, and examined their relationships with LV function and heart failure severity. The expressions of IGF-1 and IGF-1 receptor proteins were examined in endomyocardial biopsies obtained from other patients with normal or impaired LV function.
  
  
  RESULTS
  The pericardial IGF-1 and BNP levels were positively correlated with the plasma BNP level (both p < 0.001). The pericardial IGF-1 level was increased in heart failure patients, whereas the plasma IGF-1 level was rather decreased. The pericardial IGF-1 level was inversely correlated with the LV ejection fraction (p < 0.001), whereas the plasma IGF-1 level was not. Positive immunostaining for IGF-1 and IGF-1 receptor proteins was enhanced in myocardial biopsies from failing hearts compared with those from nonfailing hearts.
  
  
  CONCLUSIONS
  The pericardial IGF-1 level was increased in patients with LV dysfunction and heart failure, whereas the plasma IGF-1 level was decreased. These results may indicate that up-regulation of the cardiac IGF-1 system serves as a compensatory mechanism for LV dysfunction.
authors.affiliation: Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Abe
authors.forename: Toshiro
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kameda
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishizaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hanada
authors.forename: Kozo
authors.initials: K
authors.lastname: Fukui
authors.forename: Ikuo
authors.initials: I
authors.lastname: Fukuda
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osanai
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
mesh_terms: D000368:Aged; D002303:Cardiac Output, Low / Q000097:blood / Q000378:metabolism*; D002802:Cholinesterases / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010496:Pericardium / Q000378:metabolism; D012720:Severity of Illness Index; D015854:Up-Regulation; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000378:metabolism*
chemical_list: D020097:Natriuretic Peptide, Brain; D007334:Insulin-Like Growth Factor I; D002802:Cholinesterases