title: [Changes in serum insulin-like growth factor-1 and insulin-like growth factor-binding protein-3, and their significance in children with left-to-right shunt congenital heart disease associated with heart failure].
abstract: OBJECTIVE
  To investigate changes in serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein-3 (IGFBP-3) and their significance in children with left-to-right shunt congenital heart disease (CHD) associated with heart failure (HF).
  
  
  METHODS
  Twenty healthy children (control group), 20 children with HF, without basic heart disease (HF group), 20 children with left-to-right shunt CHD, without HF (CHD group), and 30 children with left-to-right shunt CHD associated with HF (CHD+HF group) were included in the study. These groups were compared in terms of serum IGF-1 and IGFBP-3 levels. According to the New York Heart Association (NYHA) Functional Classification, the CHD+HF group was further divided into NYHA-II, NYHA-III and NYHA-IV subgroups and the subgroups were compared in terms of serum IGF-1, IGFBP-3, and cardiac troponin I (cTnI) levels. The correlation of serum IGF-1 and IGFBP-3 levels with serum cTnI level in the CHD+HF group was analyzed.
  
  
  RESULTS
  The CHD group showed decreased serum IGF-1 and IGFBP-3 levels compared with the control group (P<0.01). The CHD+HF group showed a significantly decreased serum IGF-1 level compared with the control group (P<0.01) and CHD group (P<0.05). The HF group had significantly increased serum IGF-1 and IGFBP-3 levels compared with other groups (P<0.01). The NYHA-II subgroup had the highest serum IGF-1 level and the NYHA-IV subgroup had the lowest serum IGF-1 level (P<0.01). In the CHD+HF group, serum IGF-1 and IGFBP-3 levels were negatively correlated with serum cTnI level (r=-0.692, P<0.05; r=-0.530, P<0.05).
  
  
  CONCLUSIONS
  Serum IGF-1 level can be used as an objective condition evaluation indicator for CHD, and low serum IGF-1 level is a risk factor for HF. This also provides a clinical basis for treatment of HF using exogenous IGF-1.
authors.affiliation: Department of Cardiology, Wuhan Medical Care Center for Women and Children, Wuhan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Peng
authors.forename: Jia
authors.initials: J
authors.lastname: Fu
authors.forename: Shu-Zhen
authors.initials: SZ
authors.lastname: Deng
authors.forename: Rui-Geng
authors.initials: RG
authors.lastname: Wang
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.forename: Dong-Ming
authors.initials: DM
authors.lastname: Sun
authors.forename: Kun
authors.initials: K
authors.lastname: Xia
mesh_terms: D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood*; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D007223:Infant; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D019210:Troponin I / Q000097:blood
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D019210:Troponin I; D007334:Insulin-Like Growth Factor I