Effects of exercise training on insulin-like growth factor-I expression in the skeletal muscle of non-cachectic patients with chronic heart failure

Eur J Cardiovasc Prev Rehabil. 2005 Aug;12(4):401-6. doi: 10.1097/01.hjr.0000173106.68485.b7.


Background: Chronic heart failure (CHF) is associated with progressive muscle atrophy and reduced local expression of insulin-like growth factor I (IGF-I).

Design: The present study was designed to test the hypothesis that the local deficiency of IGF-I in the skeletal muscle of patients with CHF would respond to a 6-months aerobic training intervention. Therefore, 18 patients [mean age 52.4 (SD 4.8) years, left ventricular ejection function (LVEF) 27 (SD 6)%] were prospectively randomized to either 6 months of training or sedentary lifestyle.

Methods: Serum levels of growth hormone (GH) were measured by immunofluorometric assay, IGF-I by competitive solid phase immunoassay. IGF-I expression was assessed in vastus lateralis biopsies by real-time PCR.

Results: Exercise training led to a significant increase in peak oxygen uptake by 26% [from 20.3 (SD 3.3) ml/kg per min to 25.5 (SD 5.7) ml/kg per min, P=0.003 versus control]. Local expression of IGF-I increased significantly after exercise training by 81% [from 6.3 (SE 0.8) to 11.4 (SE 1.4) relative units, P=0.007 versus control] while IGF-I receptor expression was reduced by 33% [from 20.0 (SE 2.1) to 13.8 (SE 1.7) relative units, P=0.008 versus control]. Serum growth hormone (GH) rose modestly from 0.12 (SE 0.07) to 0.65 (SE 0.37) ng/ml in the training group (P=0.043 versus baseline), however, this change was not significant compared to the control group (P=0.848). IGF-I serum levels remained virtually unchanged.

Conclusions: Exercise training improves local IGF-I expression without significant changes of systemic parameters of the GH/IGF-I axis. These findings indicate that exercise training has the therapeutic potential to attenuate peripheral skeletal muscle alterations in particular with respect to local IGF-I expression in patients with moderate CHF.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Body Mass Index
  • Cachexia / metabolism
  • Carrier Proteins / metabolism
  • Chronic Disease
  • Exercise Test
  • Exercise*
  • Growth Hormone / metabolism
  • Heart Failure / metabolism*
  • Heart Failure / physiopathology
  • Humans
  • Insulin-Like Growth Factor Binding Protein 3 / metabolism
  • Insulin-Like Growth Factor I / biosynthesis
  • Insulin-Like Growth Factor I / metabolism*
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Oxygen Consumption
  • Prospective Studies
  • Receptor, IGF Type 1 / metabolism
  • Stroke Volume
  • Tumor Necrosis Factor-alpha / metabolism


  • Biomarkers
  • Carrier Proteins
  • Insulin-Like Growth Factor Binding Protein 3
  • Tumor Necrosis Factor-alpha
  • Insulin-Like Growth Factor I
  • Growth Hormone
  • Receptor, IGF Type 1
  • somatotropin-binding protein