Association of insulin-like growth factor-binding protein-7 levels with the presence and severity of hypertensive heart disease in patients with arterial hypertension and abdominal obesity
S Koval, O Mysnychenko, M Penkova, L Rieznik, T Starchenko, O LytvynovaAbstract
Background/Introduction
Hypertensive heart disease (HHD) is the earliest manifestation of hypertension-mediated organ damage, which rapidly progresses from an asymptomatic stage to heart failure with preserved ejection fraction (HFpEF), especially in patients with abdominal obesity (AO). Cellular senescence is currently considered an important mechanism in the pathogenesis of HFpEF, and insulin-like growth factor-binding protein 7 (IGFBP-7) is one of its markers. However, the role of IGFBP-7 in the development and progression of HHD requires further in-depth study.
Purpose
to study the relationship between IGFBP-7 serum levels and the presence and severity of HHD in patients with arterial hypertension (AH) and AO.
Methods
A total of 82 patients with stage 2-3 AH and class I-II AO were examined (34 patients without HHD, 30 patients with HHD without heart failure (HF), 18 patients with HFpEF (NYHA functional class I/II) and 25 patients with class I-II AO without AH (65 men and 42 women aged 35-59 years). The control group included 22 practically healthy individuals (13 men and 9 women) aged 20-45 years. All patients underwent general clinical laboratory and instrumental examination. IGFBP-7 serum levels were measured using a commercially available ELISA (FineTest).
Results
IGFBP-7 serum levels in patients with AO without AH (77.8 (54.2-102.6) ng/mL) and with AHand AO without HHD (123.5 (76.4-182.6) ng/mL) were higher (p<0.05) than in healthy individuals (53.8 (36.3-89.7) ng/mL). In patients with AH and AO with diagnosed HHD without HF, IGFBP-7 serum levels (168.5 (105.4-227.7) ng/mL) significantly (p<0.05) exceeded those in both healthy individuals and patients without HHD. The highest levels of IGFBP-7 were found in patients with AH and AO who developed HFpEF (168.5 (105.4-227.7) ng|mL). They were not only significantly (p<0.05) higher than in healthy individuals, in patients with AO without AH, and in patients with AH without HHD, but also in patients with HHD without HF (p=0.030). Significant (p<0.05) correlations were found between IGFBP-7 serum levels and: body mass index (BMI), left ventricular mass index (LVMI), and left atrial volume index (LAVi).
Conclusion(s)
A significant increase in IGFBP-7 serum levels was found in patients with hypertension and AO not only with established HFpEF, but also with subclinical HHD and, moreover, even in the absence of hypertension-mediated heart damage.