Increased level of pericardial insulin-like growth factor-1 in patients with left ventricular dysfunction and advanced heart failure
Increased level of pericardial insulin-like growth factor-1 in patients with left ventricular dysfunction and advanced heart failure
复制标题
DOI：
10.1016/j.jacc.2006.06.048
复制
发表时间：
2006-10-03
影响因子：
24
通讯作者：
Okumura, Ken
中科院分区：
文献类型：
--
作者：
Abe, Naoki;Matsunaga, Toshiro;Okumura, Ken
为了检验心脏胰岛素样生长因子-1（TGF-1）系统在衰竭心脏中上调的假设，我们测量了冠状动脉疾病患者的心包（心脏）和血浆（循环）IGF-1水平。心脏1GF-1系统通过增加的左心室（LV）壁应力而上调。然而，它仍然是未知的，如何影响这个系统在左心室功能不全和heartfail.Methods我们测定了87例冠心病患者接受心脏手术的血浆和心包液中的IGF-1和脑钠肽（BNP）水平，并检查其与左心室功能和心力衰竭严重程度的关系。结果心内膜1GF-1和BNP水平与血浆BNP水平呈正相关（均P <0.001），心内膜1GF-1和BNP水平与血浆BNP水平呈正相关（均P < 0.001）。心力衰竭患者心包IGF-1水平升高，而血浆IGF-1水平降低。心包IGF-1水平与左室射血分数呈负相关（p < 0.001），而血浆IGF-1水平则不相关。IGF-1和IGF-1受体蛋白的阳性免疫组化染色增强心肌活检从失败的心脏相比，从nonfail hearts.CONCLUSIONS心包IGF-1水平增加，左室功能不全和心力衰竭患者，而血浆IGF-1水平下降。这些结果可能表明，心脏IGF-1系统的上调作为左室功能障碍的代偿机制。
OBJECTIVES To test the hypothesis that the cardiac insulin-like growth factor-1 (TGF-1) system is up-regulated in the failing heart, we measured the pericardial (cardiac) and plasma (circulating) 1GF-1 levels in coronary artery disease patients.BACKGROUND Local IGF-1 systems are regulated differently from the systemic IGF-1 system. The cardiac 1GF-1 system is up-regulated by the increased left ventricular (LV) wall stress. However, it remains unknown how this system is affected in LV dysfunction and heart failure.METHODS We measured the plasma and pericardial fluid levels of IGF-1 and brain natriuretic peptide (BNP) in 87 coronary artery disease patients undergoing cardiac surgery, and examined their relationships with LV function and heart failure severity. The expressions of IGF-1 and IGF-1 receptor proteins were examined in endomyocardial biopsies obtained from other patients with normal or impaired LV function.RESULTS The pericardial 1GF-1 and BNP levels were positively correlated with the plasma BNP level (both p < 0.001). The pericardial IGF-1 level was increased in heart failure patients, whereas the plasma 1GF-1 level was rather decreased. The pericardial IGF-1 level was inversely correlated with the LV ejection fraction (p < 0.001), whereas the plasma 1GF-1 level was not. Positive immunostaining for IGF-1 and 1GF-1 receptor proteins was enhanced in myocardial biopsies from failing hearts compared with those from nonfailing hearts.CONCLUSIONS The pericardial IGF-1 level was increased in patients with LV dysfunction and heart failure, whereas the plasma IGF-1 level was decreased. These results may indicate that up-regulation of the cardiac IGF-1 system serves as a compensatory mechanism for LV dysfiinction.