Insulin resistance in heart failure: widening the divide between reduced and preserved ejection fraction?

Greene, Stephen J.; Fonarow, Gregg C.

doi:10.1002/ejhf.337

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…This suggests IGFBP-7 could compete with insulin receptors for insulin binding and interfere with the physiological response to insulin, contributing to insulin resistance and subsequently to development of diabetes and cardiovascular disease [ 26 ]. Indeed, diabetes mellitus and metabolic syndrome are known to be associated asymptomatic LVDD as well as HFpEF [ 27 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

Serum insulin-like growth factor-1 and its binding protein-7: potential novel biomarkers for heart failure with preserved ejection fraction

Barroso

Greene

Scheyer

et al. 2016

BMC Cardiovasc Disord

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BackgroundInsulin-like growth factor binding protein-7 (IGFBP-7) modulates the biological activities of insulin-like growth factor-1 (IGF-1). Previous studies demonstrated the prognostic value of IGFBP-7 and IGF-1 among patients with systolic heart failure (HF). This study aimed to evaluate the IGF1/IGFBP-7 axis in HF patients with preserved ejection fraction (HFpEF).MethodsSerum IGF-1 and IGFBP-7 levels were measured in 300 eligible consecutive patients who underwent comprehensive cardiac assessment. Patients were categorized into 3 groups including controls with normal diastolic function (n = 55), asymptomatic left ventricular diastolic dysfunction (LVDD, n = 168) and HFpEF (n = 77).ResultsIGFBP-7 serum levels showed a significant graded increase from controls to LVDD to HFpEF (median 50.30 [43.1-55.3] vs. 54.40 [48.15-63.40] vs. 61.9 [51.6-69.7], respectively, P < 0.001), whereas IGF-1 levels showed a graded decline from controls to LVDD to HFpEF (120.0 [100.8-144.0] vs. 112.3 [88.8-137.1] vs. 99.5 [72.2-124.4], p < 0.001). The IGFBP-7/IGF-1 ratio increased from controls to LVDD to HFpEF (0.43 [0.33-0.56] vs. 0.48 [0.38-0.66] vs. 0.68 [0.55-0.88], p < 0.001). Patents with IGFB-7/IGF1 ratios above the median demonstrated significantly higher left atrial volume index, E/E’ ratio, and NT-proBNP levels (all P ≤ 0.02).ConclusionIn conclusion, this hypothesis-generating pilot study suggests the IGFBP-7/IGF-1 axis correlates with diastolic function and may serve as a novel biomarker in patients with HFpEF. A rise in IGFBP-7 or the IGFBP-7/IGF-1 ratio may reflect worsening diastolic function, adverse cardiac remodeling, and metabolic derangement.

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Section: Discussionmentioning

confidence: 99%

Serum insulin-like growth factor-1 and its binding protein-7: potential novel biomarkers for heart failure with preserved ejection fraction

Barroso

Greene

Scheyer

et al. 2016

BMC Cardiovasc Disord

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“…Additionally, IR is inversely associated with survival time, independent of body composition, and other established cardiovascular risk factors [29]. Given the high prevalence of IR in HF and its well-described associations with adverse outcomes, interest in IR as a potential therapeutic target and phenotypic divisor in HF has increased in recent years [30]. …”

Section: Metabolic Dysfunction In Heart Failure: More Than Just “An Ementioning

confidence: 99%

Metabolic Dysfunction in Heart Failure: Diagnostic, Prognostic, and Pathophysiologic Insights From Metabolomic Profiling

Hunter

Kelly

McGarrah

et al. 2016

Curr Heart Fail Rep

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Metabolic impairment is an intrinsic component of heart failure (HF) pathophysiology. Although initially conceived as a myocardial defect, metabolic dysfunction is now recognized as a systemic process with complex interplay between the myocardium and peripheral tissues and organs. Specifically, HF-associated metabolic dysfunction includes alterations in substrate utilization, insulin resistance, defects in energy production, and imbalanced anabolic-catabolic signaling leading to cachexia. Each of these metabolic abnormalities is associated with significant morbidity and mortality in patients with HF; however, their detection and therapeutic management remains challenging. Given the difficulty in obtaining human cardiac tissue for research purposes, peripheral blood metabolomic profiling, a well-established approach for characterizing small-molecule metabolite intermediates from canonical biochemical pathways, may be a useful technology for dissecting biomarkers and mechanisms of metabolic impairment in HF. In this review, metabolic abnormalities in HF will be discussed with particular emphasis on the application of metabolomic profiling to detecting, risk stratifying, and identifying novel targets for metabolic therapy in this heterogeneous population.

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“…This epidemiological evidence confirmed the close relationship between heart failure and insulin resistance, suggesting that insulin resistance is an independent risk factor for the development of heart failure. However, patients with heart failure also more commonly have insulin resistance, and patients with heart failure associated with insulin resistance have a worse prognosis [ 14 ]. The occurrence of insulin resistance is time phase- and tissue-specific.…”

Section: Discussionmentioning

confidence: 99%

“…On the one hand, insulin resistance is an independent risk factor for heart failure. On the other hand, insulin resistance is also more common in patients with heart failure, and the prognosis of patients with heart failure accompanied by insulin resistance is worse [ 14 ]. Although insulin resistance alone is not sufficient to cause heart failure, it can weaken the heart's compensatory ability under stress (ischemia, pressure load, or injury).…”

Section: Introductionmentioning

confidence: 99%

Ginsenoside Rg3 ameliorates myocardial glucose metabolism and insulin resistance via activating the AMPK signaling pathway

Liu

Jiang

et al. 2022

Journal of Ginseng Research

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Insulin resistance in heart failure: widening the divide between reduced and preserved ejection fraction?

Cited by 3 publications

References 17 publications

Serum insulin-like growth factor-1 and its binding protein-7: potential novel biomarkers for heart failure with preserved ejection fraction

Serum insulin-like growth factor-1 and its binding protein-7: potential novel biomarkers for heart failure with preserved ejection fraction

Metabolic Dysfunction in Heart Failure: Diagnostic, Prognostic, and Pathophysiologic Insights From Metabolomic Profiling

Ginsenoside Rg3 ameliorates myocardial glucose metabolism and insulin resistance via activating the AMPK signaling pathway

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