Insulin-like growth factor type 2 is better than insulin-like growth factor type 1 a survival marker in patients after acute decompensation of heart failure

Abstract

Introduction: A decreased IGF-1 has been found in heart failure (HF). There are no reports assessing IGF-2 in HF, although in vitro study has shown, that IGF-2 stimulates cardiomyocyte proliferation more than IGF-1. The study aim was to compare the IGF-1 and IGF-2 concentration depending on HF exacerbation and annual survival. Material and methods: Among 75 patients hospitalized due to newly diagnosed or exacerbated HF, the following tests were determined: anthropometric measurements, basic laboratory tests, heart echocardiography, the IGF-1 and IGF-2 concentration. The annual survival was assessed. The participants were divided into NYHA II and NYHA III/IV groups. They did not differ in age, gender, BMI, WHR, HbA1c, HDL-cholesterol, and triglycerides, but differed in echocardiographic parameters, BNP, total cholesterol (TC) and LDLcholesterol levels. Nine patients (12%) died during the 12-month follow-up. Results: There were no differences in IGF-1 between NYHA groups and depending on the BMI, carbohydrate metabolism disorders and annual survival. A significantly lower IGF-2 concentration was found in NYHA III/IV vs. NYHA II: 583.71 (162.35) vs. 676.08 (172.09), p=0.02, and in those who died: 501.47(172.89) vs. 645.31(166.17) nmol/l, p=0.04. There was a positive correlation between IGF-2 and TC: r=0.28, p=0.015 and LDL: r=0.29, p=0.011 in the whole group and among patients with BMI ≥25 kg/m2: respectively for TC (r=0.31, p=0.014) and LDL (r=0.28, p=0.028). No IGF-1 correlation was found. Conclusions: Reduced IGF-2 concentration better than low IGF-1 can characterize patients with more advanced HF and a higher one-year death risk. It secretion can depend on the cholesterol concentration.