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FGF 23 is associated with disease severity and prognosis in chronic heart failure
Author(s) -
Poelzl Gerhard,
Trenkler Christian,
Kliebhan Johannes,
Wuertinger Philipp,
Seger Christoph,
Kaser Susanne,
Mayer Gert,
Pirklbauer Markus,
Ulmer Hanno,
Griesmacher Andrea
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12349
Subject(s) - medicine , heart failure , cardiology , fibroblast growth factor 23 , hazard ratio , pulmonary wedge pressure , kidney disease , heart transplantation , blood pressure , gastroenterology , parathyroid hormone , confidence interval , calcium
Background Elevated levels of fibroblast growth factor 23 ( FGF 23) are associated with incident heart failure in individuals with or without chronic kidney disease. We aimed to investigate the association between serum FGF 23 concentrations and disease severity and long‐term outcome in patients with stable heart failure. Materials and methods Serum levels of C‐term FGF23 (Ct‐FGF23) concentrations, inorganic phosphate (P i ), parathormone (PTH) and 25‐hydroxyvitamin D (25(OH)D) were measured in 208 patients with nonischaemic heart failure (age 48 ± 15 years; 70% male; NYHA Class I 27·8%, NYHA Class II 43·4%, NYHA Class III/IV 28·8%; LV‐EF 34 ± 15%; eGFR ≥60 mL/min/1·73 m 2 in 86%). Results Median Ct‐FGF23 levels were 18·2 RU/mL (7·5–40·8RU/mL). A dose–response relationship was found between median Ct‐FGF23 levels and increasing NYHA class (I: 11·9 RU/mL, II: 15·8 RU/mL, III/IV: 38·8 RU/mL; P < 0·001). Ct‐FGF23 correlated with NTproBNP ( r = 0·307, P < 0·001), central venous pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure and inversely correlated with cardiac output after adjustment for renal function ( eGFR ) and P i . LnCt‐FGF23 was related with the combined endpoint of death or heart transplantation (hazard ratio 1·452 [1·029–2·048]; P = 0·034) independent of P i , PTH, 25(OH)D, age and sex. Conclusion The phosphatonin FGF 23 is strongly associated with disease severity and long‐term outcome in patients with nonischaemic heart failure and preserved renal function. Further studies are needed to evaluate the pathophysiologic role of FGF 23 and its potential as a biomarker in heart failure.