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Increased Level of Pericardial Insulin-Like Growth Factor-1 in Patients With Left Ventricular Dysfunction and Advanced Heart Failure

Naoki Abe, MD^_*, Toshiro Matsunaga, MD^_*, Kunihiko Kameda, MD^_*, Hirofumi Tomita, MD^_*, Takayuki Fujiwara, MD^_*, Hiroshi Ishizaka, MD^_*, Hiroyuki Hanada, MD^_*, Kozo Fukui, MD, Ikuo Fukuda, MD, Tomohiro Osanai, MD^_* and Ken Okumura, MD^_*,_*

^_* Second Department of Internal Medicine
First Department of Surgery, Hirosaki University School of Medicine, Hirosaki, Japan

View larger version (29K): [in a new window]   Figure 1 (A) Relationship between age and the plasma total insulin-like growth factor-1 (IGF-1) level. (B) Relationship between age and the pericardial total IGF-1 level. (C) Relationship between the plasma and pericardial brain natriuretic peptide (BNP) levels. (D) Relationship between the plasma and pericardial total IGF-1 levels.

View larger version (13K): [in a new window]   Figure 2 Pericardial total insulin-like growth factor-1 (IGF-1) levels (A), pericardial free IGF-1 levels (B), plasma total IGF-1 levels (C), and plasma brain natriuretic peptide (BNP) levels (D) in patient groups with left ventricular ejection fraction (LVEF) values of >50%, 30% to 50%, and <30%. *p < 0.01 compared with the LVEF >50% group.

View larger version (14K): [in a new window]   Figure 3 Pericardial total insulin-like growth factor-1 (IGF-1) levels (A), pericardial free IGF-1 levels (B), plasma total IGF-1 levels (C), and plasma brain natriuretic peptide (BNP) levels (D) in patient groups with New York Heart Association (NYHA) functional classes I, II, and III. *p < 0.05 compared with class I. **p < 0.001 compared with classes I and II.

View larger version (13K): [in a new window]   Figure 4 (A) Relationship between the plasma brain natriuretic peptide (BNP) and pericardial total insulin-like growth factor-1 (IGF-1) levels. (B) Relationship between the plasma BNP and pericardial free IGF-1 levels. (C) Relationship between the plasma BNP and plasma total IGF-1 levels.

View larger version (85K): [in a new window]   Figure 5 Different degrees of immunostaining for insulin-like growth factor-1 (IGF-1) and IGF-1 receptor proteins in endomyocardial biopsy samples obtained from 3 patients. 3+ = markedly enhanced staining; 2+ = moderate staining; 1+ = weak staining. See text for discussion.