Clinical significance of serum insulin-like growth factor binding protein-7 in elderly heart failure patients with preserved ejection fraction / 中华老年医学杂志

ABSTRACT

Objective:To analyze the correlation between serum insulin-like growth factor binding protein-7(IGFBP7)levels and left ventricular diastolic function and exercise capacity in elderly heart failure patients with preserved ejection fraction(HFpEF).Methods:This was a prospective study.A total of 40 elderly patients in our hospital with HFpEF were selected as the HFpEF group, and 20 patients with normal left ventricular diastolic and systolic function were selected as the control group.Serum levels of IGFBP7 were measured by enzyme linked immunosorbent assay, while N-terminal pro-brain natriuretic peptide(NT-proBNP)was measured by chemi-lumin escence assay.The levels of biomarkers were compared between the two groups.Diastolic function was assessed by transthoracic echocardiography, exercise tolerance was assessed by cardiopulmonary exercise testing(CPET).Results:The levels of IGFBP7 in HFpEF group was significantly higher than control group[median value, 59.4 ng/L(52.2-70.6 ng/L) vs.50.8 ng/L(42.0-55.2 ng/L), P<0.01]. In multivariable analysis, NT-proBNP and IGFBP7 were independently associated with HFpEF(all P<0.05). The area under receiver operating characteristic curve of IGFBP7 and NT-proBNP for detecting HFpEF were 0.778 and 0.820, respectively(all P<0.01). Higher IGFBP7 was modestly correlated with NT-proBNP, left atrial volume index, early diastole velocity(E), E/peak late diastolic velocity(E/A), early mitral inflow velocity/annular diastolic velocity(E/e′), estimated right ventricular systolic pressure, peak oxygen uptake(VO 2 peak), anaerobic threshold and minute ventilation/earbon dioxide production(VE/VCO 2)(all P<0.05). Conclusions:In elderly patients with HFpEF, IGFBP7 may be a novel biomarker of diastolic function and exercise capacity.