Yücel YILMAZ, Fatih TANRIVERDİ, Mustafa DURAN, Mustafa ALTAY, Namık Kemal ERYOL

Serum IGF-1 düzeyleri akut miyokard infarktüsü sonrası gerçekten azalır mı ve sol ventrikül disfonksiyonu ile ilişkili midir?

Giriş; İnsülin benzeri büyüme faktörü (İGF), büyüme hormonunun primer mediatördür. İGF-1 akut miyokard infarktüsü (AMİ) sonrası miyokard fonksiyonlarının korunmasında önemli olabilir. Literatürde AMI sonrası İGF-1/İGF binding protein-3 (IGFBP-3) düzeyleri ile sol ventrikül fonksiyonları arasındaki ilişkiyi araştıran sınırlı sayıda çalışma vardır. Bizim amacımız, AMİ sonrası serum İGF-1 ve İGFBP-3 düzeylerini belirlemek ve kardiyak fonksiyonlar üzerindeki etkisini değerlendirmektir.Çalışma planı; Çalışamaya koroner yoğun bakım ünitesine yatırılan ve kabul edilme kriterlerine sahip olan 65 hasta alındı. Kontrol grubu daha önce koroner arter hastalığı olmayan ve dışlanma kriterlerine sahip olmayan 26 kişiden oluşturuldu. Hastaların kan örnekleri aç olarak yatışının ikinci gününde alındı. Serum İGF-1 ve İGFBP-3 düzeyleri ölçüldü. Hastaların ekokardiyografik değerlendirmesi ortalama yatışının 7. gününde yapıldı.Bulgular; Hasta grubunun serum İGF-1 ve İGFBP-3 düzeyleri kontrol grubuna göre daha yüksek tespit edildi. Ancak sadece IGF-1 düzeyleri (243,2 ± 87,9 ng / ml ve 177,2 ± 81,8 ng / ml p = 0.001) istatistiksel olarak anlamlı idi. Sol ventrikül (SV) duvar kalınlığı ve boşluk boyutlarındaki artış veya SV ejeksiyon fraksiyonlarındaki azalma ile İGF-1/İGFBP-3 düzeyleri arasında ilişki saptanmadı. Hasta grubunda minör kardiyak olaylar ile düşük İGF-1 düzeyleri arasında istatiksel olarak anlamlı olmayan bir ilişki tespit edildi. (253,1 ± 86,1 ve 210,5 ± 88,5 p> 0.05).Sonuç; Daha önceki benzer çalışma sonuçlarından farklı olarak AMİ sonrası serum İGF-1 düzeylerinde yükselme tespit ettik. Ancak İGF-1 düzeyleri ile hastane içi kardiyak olaylar ve ekokardiyografik parametreler arasında ilişki bulamadık. AMİ ile İGF / İGFBP düzeyleri arasındaki bağlantılar karmaşık gibi görünmektedir ve bu ilişkiyi açıklamak için daha ileri çalışmalar gereklidir.

Anahtar Kelimeler:

: İnsülin benzeri büyüme faktörü, insülin benzeri büyüme faktörü bağlayıcı proteinler, akut miyokard infarktüsü

Is IGF-1 level actually lowered in the early stage following an acute myocardial infarction and is IGF-1 associated with the left ventricle dysfunction or cardiac events?

Background: Insulin-like growth factor (IGF) is the primary mediator of growth hormone. IGF-1 may have an important role in protecting the myocardial functions following an acute myocardial infarction (AMI). Literature reveals only a limited number of studies investigating the relationship between the serum IGF-1/IGF binding protein-3 (IGFBP-3) levels and the left ventricular functions post AMI. We aimed to determine IGF-1 and IGFBP-3 levels and evaluate their effect on cardiac functions post AMI.Material and Method: Sixty five patients who were included in the study and the control group had 26 patients. Blood samples of the patients were obtained on the second day of their admission. The patients underwent echocardiographic examination on the 7th day of their hospitalization.Results: The serum IGF-1 and IGFBP-3 levels of the patient group were higher than those of the control group; however only IGF-1 levels were statistically significant (243,2±87,9 ng/mL versus 177,2±81,8 ng/mL p=0,001). The increase in the wall thickness and LV chamber size did not correlate with the decrease in LVEF and IGF-1/IGFBP-3 levels. The patients who had minor cardiac events had lower IGF-1 levels but this was not statistically significant (210.5±88.5 versus 253.1±86.1 p>0.05). Conclusion: IGF-1 and IGFBP-3 levels elevated following an the early AMI, but these markers were not correlated with the echocardiographical measurements in early post MI period.

Keywords:

Insulin-like growth factor, Insulin-like growth factor binding proteins, acute myocardial infarction,

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