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

Abstract : BACKGROUND: Anabolic 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 RESULTS: In 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. CONCLUSION: HFpEF 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.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01502236
Contributor : Laurent Jonchère <>
Submitted on : Wednesday, April 5, 2017 - 11:35:47 AM
Last modification on : Thursday, November 8, 2018 - 2:23:48 PM

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Ulrika Ljung Faxén, Camilla Hage, Lina Benson, Stanislava Zabarovskaja, Anna Andreasson, et al.. HFpEF and HFrEF Display Different Phenotypes as Assessed by IGF-1 and IGFBP-1. Journal of Cardiac Failure, Elsevier, 2017, 23 (4), pp.293-303. ⟨10.1016/j.cardfail.2016.06.008⟩. ⟨hal-01502236⟩

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