Mette Bjerre

Comparison of Prognostic Usefulness of Serum Insulin-Like Growth Factor-Binding Protein 7 in Patients With Heart Failure and Preserved Versus Reduced Left Ventricular Ejection Fraction

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  • Camilla Hage, Department of Medicine, Cardiology unit, Karolinska Institutet, Stockholm, Sweden. Electronic address:
  • ,
  • Mette Bjerre
  • Jan Frystyk
  • Harvest F Gu, Department of Urology, Karolinska University Hospital; Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
  • ,
  • Kerstin Brismar, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
  • ,
  • Erwan Donal, Département de Cardiologie & CICIT1414, Centre Hospitalier Universitaire de Rennes, Rennes, France.
  • ,
  • Jean-Claude Daubert, Département de Cardiologie & CICIT1414, Centre Hospitalier Universitaire de Rennes, Rennes, France.
  • ,
  • Cecilia Linde, University of Gothenburg
  • ,
  • Lars H Lund, University of Gothenburg

We aimed to characterize of the role of insulin-like growth factor-binding protein 7 (IGFBP-7) in heart failure (HF) pathophysiology. IGFBP-7 has been associated with cardiac hypertrophy and diastolic dysfunction in HF. In 86 patients with HF with a preserved ejection fraction (HFpEF) (ejection fraction [EF] ≥45%) and 79 with HF with a reduced ejection fraction (HFrEF), we assessed concentrations of serum IGFBP-7, correlations between serum IGFBP-7 and clinical data, diastolic function, and associations with outcome. IGFBP-7 was lower in HFpEF than HFrEF (102 vs 152 µg/L, p <0.001) and correlated with New York Heart Association class (HFpEF: r = 0.25, p = 0.020; HFrEF: r = 0.26, p = 0.022), N-terminal pro-brain natriuretic peptide (NT-proBNP) (HFpEF: r = 0.53, p <0.001; HFrEF: r = 0.50, p <0.001), and estimated glomerular filtration rate (eGFR) (HFpEF: r = -0.47, p <0.001; HFrEF: r = -0.45, p <0.001). In HFpEF, IGFBP-7 correlated with E/e' (r = 0.31, p = 0.012) and E/A ratio (r = 0.31, p = 0.011). In HFrEF, but not HFpEF, IGFBP-7 correlated with age (r = 0.29, p = 0.009) and atrial fibrillation (r = 0.34, p = 0.002). IGFBP-7 predicted the outcome in HFpEF (hazard ratio 4.19 [1.01 to 17.35], p = 0.048]) but not in HFrEF (0.72 [0.24 to 2.14], p = 0.554). In conclusion in HFrEF, IGFBP-7 was elevated and associated with HF severity but not prognostic, suggesting a marker of risk. In HFpEF, IGFBP-7 was less elevated but associated with markers of diastolic dysfunction, HF severity, and prognosis. IGFBP-7 may contribute to the progression of HFpEF possibly through inflammation and oxidative stress.

TidsskriftThe American Journal of Cardiology
Sider (fra-til)1558-1566
Antal sider9
StatusUdgivet - 15 jun. 2018

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