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    Echocardiographic assessment of insulin-like growth factor binding protein-7 and early identification of acute heart failure

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    Author
    Kalayci, A.
    Peacock, W.F.
    Christenson, R.H.
    Date
    2020
    Journal
    ESC Heart Failure
    Publisher
    Wiley-Blackwell
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1002/ehf2.12722
    Abstract
    Aims: Concentrations of insulin-like growth factor binding protein-7 (IGFBP7) have been linked to abnormal cardiac structure and function in patients with chronic heart failure (HF), but cardiovascular correlates of the biomarker in patients with more acute presentations are lacking. We aimed to determine the relationship between IGFBP7 concentrations and cardiac structure and to evaluate the impact of IGFBP7 on the diagnosis of acute HF among patients with acute dyspnoea. Methods and results: In this pre-specified subgroup analysis of the International Collaborative of N-terminal pro-B-type Natriuretic Peptide Re-evaluation of Acute Diagnostic Cut-Offs in the Emergency Department (ICON-RELOADED) study, we included 271 patients with and without acute HF. All patients presented to an emergency department with acute dyspnoea, had blood samples for IGFBP7 measurement, and detailed echocardiographic evaluation. Higher IGFBP7 concentrations were associated with numerous cardiac abnormalities, including increased left atrial volume index (LAVi; r = 0.49, P < 0.001), lower left ventricular ejection fraction (r = −0.27, P < 0.001), lower right ventricular fractional area change (r = −0.31, P < 0.001), and higher tissue Doppler E/e′ ratio (r = 0.44, P < 0.001). In multivariable linear regression analyses, increased LAVi (P = 0.01), lower estimated glomerular filtration rate (P = 0.008), higher body mass index (P = 0.001), diabetes (P = 0.009), and higher concentrations of amino-terminal pro-B-type natriuretic peptide (NT-proBNP, P = 0.02) were independently associated with higher IGFBP7 concentrations regardless of other variables. Furthermore, IGFBP7 (odds ratio = 12.08, 95% confidence interval 2.42–60.15, P = 0.02) was found to be independently associated with the diagnosis of acute HF in the multivariable logistic regression analysis. Conclusions: Among acute dyspnoeic patients with and without acute HF, increased IGFBP7 concentrations are associated with a range of cardiac structure and function abnormalities. Independent association with increased LAVi suggests elevated left ventricular filling pressure is an important trigger for IGFBP7 expression and release. IGFBP7 may enhance the diagnosis of acute HF. Copyright 2020 The Authors.
    Sponsors
    Novartis; Patient-Centered Outcomes Research Institute, PCORI; Pfizer; Portola Pharmaceuticals; National Heart, Lung, and Blood Institute, NHLBI; Agency for Healthcare Research and Quality, AHRQ; Roche; Bayer Corporation; Johnson and Johnson, J&J; Siemens Foundation; Janssen Biotech; Abbott Laboratories; Boehringer Ingelheim, BI; Merck; American Historical Association, AHA; Roche.
    Keyword
    Acute heart failure
    Dyspnoea
    Echocardiography
    IGFBP7
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084613825&doi=10.1002%2fehf2.12722&partnerID=40&md5=052ed7307dabdf30cdf8959f0a572df4; http://hdl.handle.net/10713/12813
    ae974a485f413a2113503eed53cd6c53
    10.1002/ehf2.12722
    Scopus Count
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    UMB Open Access Articles 2020

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