Low Insulin-Like Growth Factor-1 Levels Are Associated With Myocardial Mechano-Energetic Efficiency in Older Individuals

Abstract Context Altered myocardial mechano-energetic efficiency (MEE) is a substantial predictor of cardiovascular events and heart failure. Among the potential pathophysiological factors underlying MEE impairment, insulin-like growth factor 1 (IGF-1) may be a plausible candidate due to its role in the cardiovascular system. Objective This study aimed to analyze the relationship between plasma IGF-1 concentrations and myocardial MEE in a cohort of individuals older than 65 years, participating in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study. Methods Myocardial MEE per gram of left ventricular mass (MEEi) was measured in 490 older participants with a broad spectrum of glucose tolerance using echocardiography. Results IGF-1 levels were positively associated with myocardial MEEi (r = 0.200; P < .001). Individuals in the highest tertile (tertile 3) of IGF-1 showed significantly lower heart rate and myocardial oxygen consumption, alongside a significant increase in myocardial MEEi compared to those in the lowest tertile. In multivariate linear regression analysis, IGF-1 levels were identified as the major determinant of MEEi, independently of well-established cardiometabolic risk factors. Conclusion These findings suggest that low circulating IGF-1 levels are associated with depressed myocardial MEEi in older individuals. This highlights the potential importance of monitoring IGF-1 in clinical evaluations to assess cardiovascular health.