Acute Cardiovascular Effects of Insulin-Like Growth Factor I in Patients with Chronic Heart Failure¹

Abstract

Insulin-like growth factor I (IGF-I) enhances myofibrillar development in cardiomyocytes of rats in culture and in vivo. In addition, IGF-I has vasodilatory effects and improves cardiac function in healthy volunteers. This study was conducted to evaluate the acute hemodynamic effects of IGF-I in patients with chronic heart failure Eight patients with chronic heart failure were randomized to receive recombinant human IGF-I (60 micrograms/kg) or placebo, i.v., over 4 h in a cross-over, double blind study on 2 consecutive days. Electrocardiogram as well as systemic hemodynamics were continuously monitored over 7 h by flow-guided thermodilution and radial artery catheters. IGF-I was well tolerated by all patients, and no pathological changes on electrocardiogram were recorded. Compared with placebo, IGF-I increased the cardiac index by 27 +/- 3.7% (+/- SE; P < 0.0005) and the stroke volume index by 21 +/- 5.6% (P < 0.05), and decreased systemic vascular resistance by 28 +/- 4.4% (P < 0.0002), right atrial pressure by 33 +/- 9.0% (P < 0.003), and pulmonary artery wedge pressure by 25 +/- 6.1% (P < 0.03). Mean systemic and pulmonary artery pressure as well as heart rate and pulmonary vascular resistance were not significantly influenced by IGF-I treatment. Insulin and C peptide levels were decreased by IGF-I, whereas glucose and electrolyte levels remained unchanged. Urinary levels of norepinephrine decreased significantly (P < 0.05) during IGF-I infusion. Thus, acute administration of IGF-I in patients with chronic heart failure is safe and improves cardiac performance by afterload reduction and possibly by positive inotropic effects. Further investigations to establish whether the observed acute effects of IGF-I are maintained during chronic therapy appear to be warranted.

Sitagliptin protects diabetic rats with acute myocardial infarction through induction of angiogenesis: role of IGF-1 and VEGF

“…It stimulates bone growth, cell differentiation, and metabolism (Froesch, Zenobi, & Hussain, 1994). Diabetes is usually associated with low serum levels of IGF-1, and several reports have outlined the function associated with IGF-1 changes during the progress of MI and cardiovascular diseases (Donath et al, 1998;Vaessen et al, 2001). Moreover, in an ISOinduced MI in rats, treatment with IGF-1 reduced myocytes necrosis and increased capillary sprouting in the myocardium.…”

Nano-Medicine in the Cardiovascular System

“…IGF-1 is also vital in myocardial function regulation and has been demonstrated to not only promote cardiomyocyte growth but also ensure cardiomyocyte survival. Clinical studies using IGF-1 treatment, have shown that it improves myocardial function post-MI (Duerr et al, 1995;Donath et al, 1998). Unfortunately, extended IGF-1 overexpression has been shown to reduce cardiac functional recovery post-MI, making controlled delivery vital for its future use as a cardiac medicine (Prêle et al, 2012).…”