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Thus, the longer survival of patients with higher IGF-1 levels could be related to direct biological actions of IGF-1, to an overactivation of a protective GH-IGF-1 pathway or to altered IGF-1 levels in patients with a favorable metabolic status

Changes in mitochondrial bioenergetics also affect myocardial ion handling resulting in cytosolic sodium and calcium overload (Trost et al., 2002

Communicate with your pharmacy If your dosing schedule changes, such as during dose titration when you are moving from lower to higher doses, let your pharmacy know