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De Giorgi A, Marra AM, Iacoviello M, Triggiani V, Rengo G, Cacciatore F, Maiello C, Limongelli G, Masarone D, Perticone F, Filardi PP, Paolillo S, Mancini A, Volterrani M, Vriz O, Castello R, Passantino A, Campo M, Modesti PA, Salzano A, D’Assante R, Arcopinto M, Raparelli V, Fabbian F, Sciacqua A, Colao A, Suzuki T, Bossone E, Cittadini A. Insulin-like growth factor-1 (IGF-1) as predictor of cardiovascular mortality in heart failure patients: data from the T.O.S.CA. registry. Intern Emerg Med 2022; 17:1651-1660. [PMID: 35445917 PMCID: PMC9463276 DOI: 10.1007/s11739-022-02980-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/23/2022] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Data from the "Trattamento Ormonale nello Scompenso CArdiaco" (T.O.S.CA) registry showed that heart failure (HF) represents a complex clinical syndrome with different hormonal alterations. Renal failure represents a frequent complication in HF. We evaluated the relationship between renal function and insuline-like growth factor-1 (IGF-1) deficiency and its impact on cardiovascular mortality (CVM) in patients enrolled in the T.O.S.CA. registry. METHODS At the enrolment, all subjects underwent chemistry examinations, including circulating hormones and cardiovascular functional tests. COX regression analysis was used to evaluate factors related to CVM during the follow-up period in all populations, in high-risk patients and in the young-adult population. Also, we evaluate the effects of renal function on the CVM. RESULTS 337 patients (41 deceased) were analyzed. CVM was related to severe renal dysfunction (HR stages IV-V = 4.86), high-risk conditions (HR 2.25), serum IGF-1 (HR 0.42), and HF etiology (HR 5.85 and HR 1.63 for valvular and ischemic etiology, respectively). In high-risk patients, CVM was related to IGF-1 levels, severe renal dysfunction and valvular etiology, whereas in young patients CMV was related to the high-risk pattern and serum IGF-1 levels. CONCLUSIONS Our study showed the clinical and prognostic utility of the IGF-1 assay in patients with HF.
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Affiliation(s)
- Alfredo De Giorgi
- grid.416315.4Clinica Medica Unit, Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy
| | - Alberto Maria Marra
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University, Naples, Italy
- grid.5253.10000 0001 0328 4908Italian Clinical Outcome Research and Reporting Program (I-CORRP)-Center for Pulmonary Hypertension, Thorax Clinic at Heidelberg University Hospital, Heidelberg, Germany
| | - Massimo Iacoviello
- grid.10796.390000000121049995Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Triggiani
- grid.7644.10000 0001 0120 3326Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari ‘A Moro’, Bari, Italy
| | - Giuseppe Rengo
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University, Naples, Italy
- grid.511455.1Istituti Clinici Scientifici Maugeri SpA Società Benefit-IRCCS-Scientific Institute of Telese Terme, Telese Terme, Italy
| | - Francesco Cacciatore
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Ciro Maiello
- grid.416052.40000 0004 1755 4122Heart Transplantation Unit, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Giuseppe Limongelli
- grid.416052.40000 0004 1755 4122Division of Cardiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, University of Campania L. Vanvitelli, Caserta, Italy
| | - Daniele Masarone
- grid.416052.40000 0004 1755 4122Division of Cardiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, University of Campania L. Vanvitelli, Caserta, Italy
| | - Francesco Perticone
- grid.411489.10000 0001 2168 2547Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Pasquale Perrone Filardi
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, Federico II University, Naples, Italy
- grid.477084.80000 0004 1787 3414Mediterranea Cardiocentro, Naples, Italy
| | - Stefania Paolillo
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, Federico II University, Naples, Italy
- grid.477084.80000 0004 1787 3414Mediterranea Cardiocentro, Naples, Italy
| | - Antonio Mancini
- grid.8142.f0000 0001 0941 3192Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy
| | - Maurizio Volterrani
- grid.18887.3e0000000417581884Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Olga Vriz
- grid.415310.20000 0001 2191 4301Heart Center Department, King Faisal Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Roberto Castello
- grid.411475.20000 0004 1756 948XDivision of General Medicine, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Andrea Passantino
- grid.414603.4Scientific Clinical Institutes Maugeri, IRCCS, Pavia, Italy
| | - Michela Campo
- grid.10796.390000000121049995Unit of Endocrinology and Metabolic Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pietro Amedeo Modesti
- grid.8404.80000 0004 1757 2304Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Florence, Italy
| | - Andrea Salzano
- grid.482882.c0000 0004 1763 1319Italian Clinical Outcome Research and Reporting Program (I-CORRP)-IRCCS SDN, Diagnostic and Nuclear Research Institute, Naples, Italy
| | - Roberta D’Assante
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University, Naples, Italy
- Italian Clinical Outcome Research and Reporting Program (I-CORRP), Naples, Italy
| | - Michele Arcopinto
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University, Naples, Italy
- Italian Clinical Outcome Research and Reporting Program (I-CORRP), Naples, Italy
| | - Valeria Raparelli
- grid.8484.00000 0004 1757 2064Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Fabio Fabbian
- grid.416315.4Clinica Medica Unit, Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy
- grid.8484.00000 0004 1757 2064Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Angela Sciacqua
- grid.411489.10000 0001 2168 2547Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Annamaria Colao
- grid.4691.a0000 0001 0790 385XClinical Medicine and Surgery Department, Federico II University, Naples, Italy
| | - Toru Suzuki
- grid.412925.90000 0004 0400 6581Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Eduardo Bossone
- grid.413172.2Italian Clinical Outcome Research and Reporting Program (I-CORRP)-Cardiology Division, A. Cardarelli Hospital, Naples, Italy
| | - Antonio Cittadini
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University, Naples, Italy
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Lang X, Li Y, Zhang D, Zhang Y, Wu N, Zhang Y. FT3/FT4 ratio is correlated with all-cause mortality, cardiovascular mortality, and cardiovascular disease risk: NHANES 2007-2012. Front Endocrinol (Lausanne) 2022; 13:964822. [PMID: 36060933 PMCID: PMC9433660 DOI: 10.3389/fendo.2022.964822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Thyroid hormones play a vital role in maintaining the homeostasis of the cardiovascular system. The FT3/FT4 ratio can be used to evaluate the rate of T4-to-T3 conversion, reflecting the peripheral sensitivity of thyroid hormones. There is no study to investigate its relationship with death and cardiovascular disease (CVD) in the general population. METHODS This retrospective cohort study involved 8,018 participants with measured thyroid function and no prior thyroid disease who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. Mortality status was determined by routine follow-up using the National Death Index through December 31, 2015. RESULTS During a median of 87 months of follow-up, we observed 699 all-cause deaths, including 116 cardiovascular deaths. In multivariate adjusted models, higher free thyroxine (FT4) was linked to increased all-cause mortality (HR, 1.15 per SD; 95% CI, 1.09-1.22), cardiovascular mortality (HR, 1.18 per SD; 95% CI, 1.01-1.39), and CVD risk (HR, 1.17 per SD; 95% CI, 1.08-1.27). Higher free triiodothyronine (FT3) was linked to decreased all-cause mortality (HR 0.81 per SD; 95% CI, 0.70-0.93). Higher FT3/FT4 ratio was linked to decreased all-cause mortality (HR, 0.77 per SD; 95% CI, 0.69-0.85), cardiovascular mortality (HR, 0.79 per SD; 95% CI, 0.62-1.00), and CVD risk (HR, 0.82 per SD; 95% CI, 0.74-0.92). The FT3/FT4 ratio stratified findings were broadly consistent with the overall results. CONCLUSIONS FT3, FT4, and the FT3/FT4 ratio were all independent predictors of all-cause death. FT4 and the FT3/FT4 ratio, but not FT3, were independent predictors of cardiovascular mortality and CVD risk. Along with FT3 and FT4, we should pay equal attention to the FT3/FT4 ratio in the general population.
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Affiliation(s)
- Xueyan Lang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Yilan Li
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Dandan Zhang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Yuheng Zhang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Nilian Wu
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yao Zhang
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
- *Correspondence: Yao Zhang,
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Kirkman DL, Bohmke N, Billingsley HE, Carbone S. Sarcopenic Obesity in Heart Failure With Preserved Ejection Fraction. Front Endocrinol (Lausanne) 2020; 11:558271. [PMID: 33117276 PMCID: PMC7561426 DOI: 10.3389/fendo.2020.558271] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a public health epidemic that is projected to double over the next two decades. Despite the high prevalence of HFpEF, there are currently no FDA approved therapies for health-related outcomes in this clinical syndrome making it one the greatest unmet needs in cardiovascular medicine. Aging and obesity are hallmarks of HFpEF and therefore there is a high incidence of sarcopenic obesity (SO) associated with this syndrome. The presence of SO in HFpEF patients is noteworthy as it is associated with co-morbidities, worsened cardiovascular health, hospitalizations, quality of life, and mortality. Furthermore, SO plays a central role in exercise intolerance, the most commonly reported clinical symptom of this condition. The aim of this review is to provide insights into the current knowledge pertaining to the contributing pathophysiological mechanisms and clinical outcomes associated with HFpEF-related SO. Current and prospective therapies to address SO in HFpEF, including lifestyle and pharmaceutical approaches, are discussed. The urgent need for future research aimed at better understanding the multifaceted physiological contributions to SO in HFpEF and implementing interventional strategies to specifically target SO is highlighted.
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Bruno C, Silvestrini A, Calarco R, Favuzzi AMR, Vergani E, Nicolazzi MA, d'Abate C, Meucci E, Mordente A, Landolfi R, Mancini A. Anabolic Hormones Deficiencies in Heart Failure With Preserved Ejection Fraction: Prevalence and Impact on Antioxidants Levels and Myocardial Dysfunction. Front Endocrinol (Lausanne) 2020; 11:281. [PMID: 32477267 PMCID: PMC7235369 DOI: 10.3389/fendo.2020.00281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/15/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose: In heart failure with reduced ejection fraction, catabolic mechanisms have a strong negative impact on mortality and morbidity. The relationship between anabolic hormonal deficiency and heart failure with preserved ejection fraction (HFpEF) has still been poorly investigated. On the other hand, oxidative stress is recognized as a player in the pathogenesis of HFpEF. Therefore, we performed a cohort study in HFpEF aimed to (1) define the multi-hormonal deficiency prevalence in HFpEF patients; (2) investigate the relationships between hormonal deficiencies and echocardiographic indexes; (3) explore the modulatory activity of anabolic hormones on antioxidant systems. Methods: 84 patients with diagnosis of HFpEF were enrolled in the study. Plasma levels of N-terminal pro-brain natriuretic peptide, fasting glucose, insulin, lipid pattern, insulin-like growth factor-1, dehydroepiandrosterone-sulfate (DHEA-S), total testosterone (T, only in male subjects) were evaluated. Hormonal deficiencies were defined according to T.O.S.C.A. multi-centric study, as previously published. An echocardiographic evaluation was performed. Plasma total antioxidant capacity (TAC) was measured using the system metmyoglobin -H2O2 and the chromogen ABTS, whose radical form is spectroscopically revealed; latency time (LAG) in the appearance of ABTS• is proportional to antioxidants in sample. Results: Multiple deficiencies were discovered. DHEA-S deficiency in 87% of patients, IGF-1 in 67% of patients, T in 42%. Patients with DHEA-S deficiency showed lower levels of TAC expressed by LAG (mean ± SEM 91.25 ± 9.34 vs. 75.22 ± 4.38 s; p < 0.05). No differences between TAC in patients with or without IGF-1 deficiency were found. A trend toward high level of TAC in patients without hormonal deficiencies compared with patients with one or multiple deficiencies was found. Regarding echocardiographic parameters, Left Atrial and Left Atrial Volume Index were significantly higher in patients with low IGF-1 values (mean ± SD 90.84 ± 3.86 vs. 72.83 ± 3.78 mL; 51.03 ± 2.33 vs. 40.56 ± 2.46 mL/m2, respectively; p < 0.05). Conclusions: Our study showed high prevalence of anabolic deficiencies in HFpEF. DHEA-S seems to influence antioxidant levels; IGF-1 deficiency was associated with alteration in parameters of myocardial structure and dysfunction. These data suggest a role of anabolic hormones in the complex pathophysiological mechanisms of HFpEF and could represent the basis for longitudinal studies and investigations on possible benefits of replacement therapy.
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Affiliation(s)
- Carmine Bruno
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Andrea Silvestrini
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- *Correspondence: Andrea Silvestrini
| | - Rodolfo Calarco
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Angela M. R. Favuzzi
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Edoardo Vergani
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Maria Anna Nicolazzi
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Claudia d'Abate
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Elisabetta Meucci
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alvaro Mordente
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaele Landolfi
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
| | - Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario a Gemelli IRCCS, Rome, Italy
- Antonio Mancini
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