Time-related changes in growth hormone and insulin-like growth factor 1 in blood of patients with decompensated chronic heart failure as a marker for prognosis and therapy efficacy
Dronova A. V., Sitnikova M. Yu., Grineva E. N., Shlyakhto E. V., Solntsev V. N.
Keywords: NT-fragment of brain natriuretic peptide, growth hormone, insulin-like growth factor 1, prognosis, CHF
Background. Multiple clinical and laboratory tests are presently used for determining the CHF prognosis and severity. However, accurate prediction of HF course is still unfeasible. This is why searching for new predictors of life span and therapy efficacy in CHF patients has been continued. Aim. Studying serum levels of growth hormone (GH) and insulin-like growth factor 1 (ILGF-1) and their ratio (ILGF-1 / GH) in patients with CHF of ischemic origin to identify predictors of the disease course, therapy efficacy and prognosis. Materials and methods. The study included 53 men aged 47 to 75 years (main groups) who were admitted for progressive symptoms of systolic CHF (LV EF ≤45 %). The control group consisted of 13 men aged 49 to 69 years who had IHD with preserved LV EF according to echoCG data (>60 %). Results. On admission, the ILGF-1 / GH ratio was lower in patients who had FC III CHF at 6 months of follow-up than in patients, who had FC II CHF at 6 months of follow-up (р=0.02). At 6 months of follow-up, the decrease in GH level was markedly greater in patients with FC II CHF than in patients with FC III CHF (almost by two thirds and less than by half, respectively). Patients who died had had initially (at stage of decompensated CHF) significantly lower ILGR-1 / GH ratio than those who survived (р=0.01); this ratio remained the same after the condition was stabilized in the hospital (р=0.03). Conclusion. In decompensated CHF, persistence of high CHF FC at 6 months of follow-up was predicted by blood GH >1.9 mIU / l and ILGF1 / GH ratio <320. ILGF-1 / GH ratios below 130 at the stage of decompensated CHF were associated with a risk of fatal outcome in patients with FC III–IV CHF of ischemic origin. A close correlation was found between blood levels of GH and NTfragment of brain natriuretic peptide at stages of decompensated CHF, CHF stabilization, and at 6 months of hospitalization.
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Dronova A. V., Sitnikova M. Yu., Grineva E. N. et al. Time-related changes in growth hormone and insulin-like growth factor 1 in blood of patients with decompensated chronic heart failure as a marker for prognosis and therapy efficacy. Russian Heart Failure Journal. 2013;14 (6):329-333