NT-proBNP, IGF-I and survival in patients with chronic heart failure

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• 作者：Mario Petretta ; Annamaria Colao ; Celestino Sardu ; Franco Scopacasa ; Paolo Marzullo ; Rosario Pivonello ; Luca Fontanella ; Maurizio de Caterina ; Adriano de Simone ; Domenico Bonaduce
• 关键词：NT-proBNP ; IGF-I ; GH ; Chronic heart failure ; Prognosis
• 刊名：Growth Hormone & IGF Research
• 出版年：2007
• 出版时间：August 2007
• 年：2007
• 卷：17
• 期：4
• 页码：288-296
• 全文大小：431 K

文摘

Growth hormone (GH) resistance with a reduction of insulin-like growth factor-I (IGF-I) serum concentrations seems to be implicated in the catabolic process associated with chronic heart failure (CHF). However, data concerning the prognostic value of these alterations in CHF patients without cachexia are scant. In this study, we aimed to determine in CHF patients the prognostic value of IGF-I/GH ratio and its relationships with N-terminal brain natriuretic peptide (NT-proBNP), a known marker of prognosis in these patients.

Design

We enrolled 82 non-cachectic patients, mean age 61 ± 13 years, with ejection fraction <40 % and predischarge New York Heart Association (NYHA) functional classes II–IV. All patients underwent clinical examination, two-dimensional echocardiography and NT-proBNP, GH and IGF-I measurement with log IGF-I/GH ratio calculation. Mortality and clinical status was documented at follow-up (18.4 ± 8.1 months).

Results

During follow-up 17 patients died of cardiac causes. Non-survivors were at baseline in higher NYHA class (P < 0.05) and showed higher values of NT-proBNP (P < 0.001) than survivors; differently IGF-I, and log IGF-I/GH ratio were lower (P < 0.05). At Cox multivariate analysis, NT-proBNP (P < 0.001) and IGF-I/GH ratio (P < 0.05) were independent predictors of death.

Conclusions

High NT-proBNP levels and low IGH-I/GH ratio may be useful to stratify CHF patients at higher risk of cardiac death.