Insulin-Like Growth Factor-Binding Protein-7 as a Biomarker of Diastolic Dysfunction and Functional Capacity in Heart Failure With Preserved Ejection Fraction: Results From the RELAX Trial.
Insulin-Like Growth Factor-Binding Protein-7 as a Biomarker of Diastolic Dysfunction and Functional Capacity in Heart Failure With Preserved Ejection Fraction: Results From the RELAX Trial.
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DOI：
10.1016/j.jchf.2016.08.002
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Januzzi JL Jr
中科院分区：
文献类型：
--
作者：
Gandhi PU;Gaggin HK;Redfield MM;Chen HH;Stevens SR;Anstrom KJ;Semigran MJ;Liu P;Januzzi JL Jr
研究胰岛素样生长因子结合蛋白7（IGFBP 7）与心力衰竭和射血分数保留（HFpEF）患者舒张功能或功能容量参数之间的关系，随机接受西地那非或安慰剂。先前发现IGFBP 7与EF降低的HF的舒张功能相关，但尚不清楚这些相关性是否存在于HFpEF中。在基线和24周时，获得IGFBP 7、成像研究和峰值耗氧量（VO 2 max），并在160名HFpEF患者中进行比较，这些患者随机接受西地那非或安慰剂治疗。基线IGFBP 7浓度高于中位数的患者年龄较大，有全身充血和肾功能恶化的迹象，并且具有较高浓度的预后HF生物标志物，包括氨基末端前B型利钠肽（P<0.05）。较高的基线IGFBP 7与较差的舒张功能适度相关：较高的E速度（ρ=0.40）、E/E'（ρ=0.40）、左心房容积指数（ρ=0.39）和估计的右心室收缩压（RVSP; ρ=0.41;所有P<0.001），与二尖瓣E/A弱相关（ρ=0.26，P=0.006）。值得注意的是，IGFBP 7的变化（Δ）与E、E/A、E/E '和RVSP的变化显著相关。基线IGFBP 7升高与基线VO 2 max降低相关（13.2 vs 11.1 mL/min/kg; P<0.001），Δ IGFBP 7与Δ VO 2 max呈弱负相关（ρ=-0.19，P=0.01）。与安慰剂治疗的患者相比，接受西地那非治疗的受试者在24周内IGFBP 7降低（中位Δ IGFBP 7 −1.5 vs +13.6 ng/mL; P<0.001）。在HFpEF患者中，IGFBP 7可能是舒张功能和运动能力的新生物标志物。
To investigate relationships between insulin-like growth factor-binding protein 7 (IGFBP7) and parameters of diastolic function or functional capacity in patients with heart failure and preserved ejection fraction (HFpEF), randomized to receive sildenafil or placebo. IGFBP7 was previously found to be associated with diastolic function in HF with reduced EF, but it is unclear whether these associations are present in HFpEF. At baseline and 24 weeks, IGFBP7, imaging studies, and peak oxygen consumption (VO2max) were obtained and compared in 160 HFpEF patients randomized to receive sildenafil or placebo. Patients with supramedian baseline IGFBP7 concentrations were older, had signs of systemic congestion and worse renal function, and had higher concentrations of prognostic HF biomarkers including amino-terminal pro-B-type natriuretic peptide (P<0.05). Higher baseline IGFBP7 was modestly correlated with worse diastolic function: higher E velocity (ρ=0.40), E/E’ (ρ=0.40), left atrial volume index (ρ=0.39), and estimated right ventricular systolic pressure (RVSP; ρ=0.41; all P<0.001) and weakly correlated with transmitral E/A (ρ=0.26, P=0.006). Notably, change (Δ) in IGFBP7 was significantly correlated with change in E, E/A, E/E’, and RVSP. Elevated baseline IGFBP7 was associated with lower baseline VO2max (13.2 versus 11.1 mL/min/kg; P<0.001) and ΔIGFBP7 was weakly inversely correlated with ΔVO2max (ρ=−0.19, P=0.01). Subjects receiving sildenafil had a decrease in IGFBP7 over 24 weeks, in contrast to placebo-treated patients (median ΔIGFBP7 −1.5 versus +13.6 ng/mL; P<0.001). In patients with HFpEF, IGFBP7 may be a novel biomarker of diastolic function and exercise capacity.
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影响因子：
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作者：
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通讯作者：
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DOI：
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