IGF1 and hydrops fetalis: Conversely, treatment-naïve acromegaly patients, characterized by excessively high IGF-1 levels, showed a significantly higher incidence of both diastolic HF [odds ratio (OR) 9.08; 95% CI 6.20–13.29; p < 0.01] and systolic HF (OR 13.1; 95% CI 6.64–25.84; p < 0.01), implicating supraphysiological IGF-1 levels in adverse cardiac outcomes.