title: Serum insulin-like growth factor-1 and its binding protein-7: potential novel biomarkers for heart failure with preserved ejection fraction.
abstract: Insulin-like growth factor binding protein-7 (IGFBP-7) modulates the biological activities of insulin-like growth factor-1 (IGF-1). Previous studies demonstrated the prognostic value of IGFBP-7 and IGF-1 among patients with systolic heart failure (HF). This study aimed to evaluate the IGF1/IGFBP-7 axis in HF patients with preserved ejection fraction (HFpEF).
  
  
  
  Serum IGF-1 and IGFBP-7 levels were measured in 300 eligible consecutive patients who underwent comprehensive cardiac assessment. Patients were categorized into 3 groups including controls with normal diastolic function (n = 55), asymptomatic left ventricular diastolic dysfunction (LVDD, n = 168) and HFpEF (n = 77).
  
  
  
  IGFBP-7 serum levels showed a significant graded increase from controls to LVDD to HFpEF (median 50.30 [43.1-55.3] vs. 54.40 [48.15-63.40] vs. 61.9 [51.6-69.7], respectively, P < 0.001), whereas IGF-1 levels showed a graded decline from controls to LVDD to HFpEF (120.0 [100.8-144.0] vs. 112.3 [88.8-137.1] vs. 99.5 [72.2-124.4], p < 0.001). The IGFBP-7/IGF-1 ratio increased from controls to LVDD to HFpEF (0.43 [0.33-0.56] vs. 0.48 [0.38-0.66] vs. 0.68 [0.55-0.88], p < 0.001). Patents with IGFB-7/IGF1 ratios above the median demonstrated significantly higher left atrial volume index, E/E' ratio, and NT-proBNP levels (all P ≤ 0.02).
  
  
  
  In conclusion, this hypothesis-generating pilot study suggests the IGFBP-7/IGF-1 axis correlates with diastolic function and may serve as a novel biomarker in patients with HFpEF. A rise in IGFBP-7 or the IGFBP-7/IGF-1 ratio may reflect worsening diastolic function, adverse cardiac remodeling, and metabolic derangement.
authors: Klinik Königsfeld der Deutschen Rentenversicherung Westfalen in Ennepetal (NRW), University Hospital, Witten/Herdecke, Germany.
authors: Michael Coll
authors: MC
authors: Barroso
authors: Drug Discovery, Clinical Sciences - Experimental Medicine, Bayer Pharma AG, Leverkusen, Germany.
authors: Frank
authors: F
authors: Kramer
authors: Division of Cardiology, Duke University Medical Center, Durham, NC, USA.
authors: Stephen J
authors: SJ
authors: Greene
authors: Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany.
authors: Daniel
authors: D
authors: Scheyer
authors: Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany.
authors: Till
authors: T
authors: Köhler
authors: Klinik Königsfeld der Deutschen Rentenversicherung Westfalen in Ennepetal (NRW), University Hospital, Witten/Herdecke, Germany.
authors: Martin
authors: M
authors: Karoff
authors: Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany.
authors: Melchior
authors: M
authors: Seyfarth
authors: Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, USA.
authors: Mihai
authors: M
authors: Gheorghiade
authors: Drug Discovery, Clinical Sciences - Experimental Medicine, Bayer Pharma AG, Leverkusen, Germany. Wilfried.dinh@bayer.com.|Department of Cardiology, HELIOS Clinic Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany. Wilfried.dinh@bayer.com.
authors: Wilfried
authors: W
authors: Dinh
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003971:Diastole; D015150:Echocardiography, Doppler; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D018969:Insulin-Like Growth Factor Binding Proteins; C102529:insulin-like growth factor binding protein-related protein 1; D007334:Insulin-Like Growth Factor I
keywords: Heart failure; IGF-1; IGFBP-7; Preserved