Importantly, AH is also an independent predictor of mortality in AC patients, with the following factors potentially contributing to the development of AH in this patient group: rapid HR, increased LV afterload, increased SV and CO, endothelial dysfunction, changes in systemic vascular resistance, and reduced coronary perfusion pressure (24, 40), with direct antidiuretic effects of GH and IGF-1 in the kidneys also playing an important role (41). Here, IGF1 is linked to endothelial dysfunction.