Article Text

PDF
Insulin-like growth factor-binding proteins 2 and 3 are independent predictors of a poor prognosis in patients with dilated cardiomyopathy
  1. Sabine Hassfeld1,
  2. Christina Eichhorn2,
  3. Katja Stehr3,
  4. Herbert Naegele4,
  5. Christian Geier1,
  6. Martin Steeg1,
  7. Michael B Ranke5,
  8. Cemil Oezcelik1,
  9. Karl Josef Osterziel1
  1. 1Department of Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany
  2. 2Max-Delbrueck-Center for Molecular Medicine, Berlin, Germany
  3. 3University Clinic Hamburg-Eppendorf, Hamburg, Germany
  4. 4Hospital Reinbek, St Adolfs Stift, Reinbek, Germany
  5. 5Paediatric Endocrinology Section, University Children’s Hospital, Eberhard-Karls University, Tuebingen, Germany
  1. Correspondence to:
    Dr S Hassfeld
    Department of Cardiology, Charité Universitätsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany; s.hassfeld{at}mdc-berlin.de

Statistics from Altmetric.com

Growth hormone and its mediator insulin-like growth factor 1 (IGF1) exert various actions on the growth and proliferation of myocardium and many other cell types. IGF1 is predominantly bound to at least six binding proteins (IGFBP1–6). Growth hormone is the major hormonal factor controlling IGF1 and IGFBP concentrations. Tissue concentrations, bioavailability and effects of IGF1 are regulated by modifications of IGFBP affinities through proteolysis, phosphorylation and binding to cell surfaces.1

In a failing myocardium, growth hormone and IGF1 improve cardiac haemodynamics, normalise the calcium homoeostasis and support an efficient myocardial energy metabolism.2 However, analyses of the IGF1 serum levels in patients with congestive heart failure (CHF) from different causes showed increased as well as unchanged levels. Furthermore, despite improvements of cardiac function in several small open growth hormone-substitution studies, these effects could not be confirmed in two large randomised double-blind studies.2 Nevertheless, we observed a marked increase of the left ventricular ejection fraction in patients with a pronounced increase of IGF1 serum levels during recombinant human growth hormone treatment.3 Thus, we assume that the growth hormone/IGF-system is differently altered in patients with CHF due to different causes and might influence the course of the disease.

METHODS

We examined 90 patients with idiopathic dilated cardiomyopathy between 1992 and 1997 after exclusion of secondary forms and …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.