title: Plasma insulin-like growth factor I as predictor of progression and all cause mortality in chronic heart failure.
abstract: OBJECTIVE
  Insulin-like growth factor I (IGF-I) is an anabolic growth factor that seems to increase cardiac contractility. Reduced levels of IGF-I may be implicated in progression of CHF. The objective was to compare plasma IGF-I in CHF patients with healthy controls, and to examine the associations between baseline IGF-I levels, cardiac contractility and the prognosis as judged by all cause mortality and progression of CHF requiring admission to hospital.
  
  
  METHODS
  A prospective study comprising 194 CHF outpatients, and 169 matched controls. All patients and controls underwent echocardiographic examination at baseline. Patients were followed for a median of 30 months.
  
  
  RESULTS
  There was no difference in IGF-I levels between patients and controls (median and interquartile range), 78 (58-91) vs. 77 (57-94)ng/mL (P=0.92). Age-adjusted IGF-I levels were not related to left ventricular ejection fraction (LVEF) (P=0.58) or levels of N-terminal B-Type natriuretic peptide (NT-proBNP) (P=0.42). During follow-up 44 patients died and 94 were admitted to hospital due to worsening of CHF. Adjusted for cardiovascular risk factors (age, gender, NT-proBNP, lipids, diabetes mellitus, blood pressure, renal function and LVEF) IGF-I levels did not influence the overall mortality risk or the admission rate to hospital, hazard ratio (HR) (95% confidence intervals) 1.05 (0.75-1.47) (P=0.77) and 1.00 (0.80-1.26) (P=0.96), respectively per each SD increase in log IGF-I levels.
  
  
  CONCLUSIONS
  IGF-I levels were not reduced in patients with CHF and did not influence cardiac status at baseline or the prognosis.
authors.affiliation: Department of Endocrinology J, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark. andreassenmikkel@hotmail.com
authors.forename: Mikkel
authors.initials: M
authors.lastname: Andreassen
authors.forename: Caroline
authors.initials: C
authors.lastname: Kistorp
authors.forename: Ilan
authors.initials: I
authors.lastname: Raymond
authors.forename: Per
authors.initials: P
authors.lastname: Hildebrandt
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
authors.forename: Lars Østergaard
authors.initials: LØ
authors.lastname: Kristensen
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007334:Insulin-Like Growth Factor I