Association between Circulating Fibroblast Growth Factor 23, α-Klotho, and the Left Ventricular Ejection Fraction and Left Ventricular Mass in Cardiology Inpatients

Abstract Objectives To determine the association of fibroblast growth factor 23 (FGF23) with left ventricular hypertrophy (LVH) through the assessment of left ventricular (LV) mass and left ventricular mass index (LVMI) in patients on hemodialysis, this study was done. Methods All patients on hemodialysis who are older than 18 years and in whom hemodialysis vintage was at least 6 months were enrolled. All patients were on hemodialysis thrice a week for 4 h using low-flux dialysis filters, polysulfone membranes, reverse osmosis purified water, and bicarbonate-base hemodialysis solution. The exclusion criteria were any respiratory illness or pulmonary infection, cigarette smoking, and the presence of pericarditis or pericardial effusion. Additionally, patients with a known coronary artery disease, any form of cardiac arrhythmias, any cardiomyopathy or severe valvular heart disease diagnosed by echocardiography, acute congestive heart failure (CHF), and acute myocardial infarction were not included. Echocardiography was conducted by an experienced operator for all the enrolled patients using the ACUSON SC2000™ ultrasound system transducer (Siemens), with a frequency bandwidth of: 1.5–3.5 MHz. Patients were considered to have LVH if the LVMI was greater than 134 g/m2 for men and greater than 110 g/m2 for women. Results A total of 61 patients (19 female and 42 male) were enrolled to the study. Mean (± SD) age of the patients was 59.6 ± 13.1 years. The median duration of hemodialysis was 23 (range: 6–120) months. The median predialysis level of FGF23 was 1,977 pg/mL (range: 155–8,870). LVH was seen in 73.8% of the patients (n = 45) and of them 66.7% were male. There was a statistically significant direct correlation between FGF23 and left ventricle diameter in end systole (LVDs) (r = 0.29, P = 0.027). However, the association of FGF23 with LV mass, LVMI, and left ventricular ejection fraction (LVEF) was not significant. Conclusion This study does not show the correlation between FGF23 and LV mass in stable hemodialysis patients.

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DECREASES IN LEFT VENTRICULAR MASS AND NOT LEFT VENTRICULAR EJECTION FRACTION ARE ASSOCIATED WITH HEART FAILURE SYMPTOMS IN CANCER PATIENTS SIX MONTHS AFTER POTENTIALLY CARDIOTOXIC CHEMOTHERAPY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(17)34799-x ◽

2017 ◽

Vol 69 (11) ◽

pp. 1410 ◽

Cited By ~ 2

Author(s):

Jennifer H. Jordan ◽

Giselle Melendez ◽

Cynthia Suerken ◽

Ralph D'Agostino ◽

W. Hundley

Keyword(s):

Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Cancer Patients ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Ventricular Mass

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Effects of ramipril on left ventricular mass and function in cardiovascular patients with controlled blood pressure and with preserved left ventricular ejection fraction

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2003.10.073 ◽

2004 ◽

Vol 43 (12) ◽

pp. 2200-2206 ◽

Cited By ~ 59

Author(s):

Eva Lonn ◽

Roya Shaikholeslami ◽

Qilong Yi ◽

Jackie Bosch ◽

Brian Sullivan ◽

...

Keyword(s):

Blood Pressure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Cardiovascular Patients ◽

And Function

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Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years. The Cardiovascular Health Study

ACC Current Journal Review ◽

10.1016/j.accreview.2004.11.064 ◽

2004 ◽

Vol 13 (12) ◽

pp. 27-28 ◽

Cited By ~ 2

Author(s):

M.H. Drazner ◽

J.E. Rame ◽

E.K. Marino

Keyword(s):

Risk Factor ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular Mass ◽

Cardiovascular Health ◽

Left Ventricular ◽

Health Study ◽

Left Ventricular Ejection ◽

Cardiovascular Health Study ◽

Ventricular Ejection Fraction

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Χαμηλής συχνότητας νευρομυϊκή ηλεκτρική διέγερση των σκελετικών μυών των κάτω άκρων και νεοαγγειογένεση σε ασθενείς με χρόνια καρδιακή ανεπάρκεια με χαμηλό κλάσμα εξώθησης

10.12681/eadd/43801 ◽

2018 ◽

Author(s):

Νικόλαος Μαγκούτης

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Walking Distance ◽

Left Ventricular Ejection ◽

Vascular Endothelial ◽

Ventricular Ejection Fraction ◽

Endothelial Growth Factor

Εισαγωγή: Η χαμηλής συχνότητας νευρομυική ηλεκτρική διέγερση (ΝΜΗΔ) των σκελετικών μυών των κάτω άκρων, μία εναλλακτική μορφή άσκησης σε ασθενείς που δεν είναι σε θέση ή δεν θέλουν να ασκηθούν φυσικά, βελτιώνει την κλινική εικόνα και αγγειοδιασταλτική ικανότητα των ασθενών με καρδιακή ανεπάρκεια (ΚΑ). Προσπαθήσαμε, λοιπόν, να εκτιμήσουμε την επίδραση της ΝΜΗΔ στα επίπεδα του αυξητικού παράγοντα Α του αγγειακού ενδοθηλίου (Vascular Endothelial Growth Factor-A, VEGF-A), των ενδοθηλιακών προγονικών κυττάρων (Endothelial Progenitor Cells, EPCs), και των CD34+ κυττάρων σε ασθενείς με ΚΑ με χαμηλό κλάσμα εξώθησης της αριστερής κοιλίας (Left Ventricular Ejection Fraction, LVEF) (<40%).Μέθοδοι: Τυχαιοποιήσαμε 27 αθενείς με ΚΑ με χαμηλό κλάσμα εξώθησης, ηλικίας 72 ετών, με συμπτώματα κατηγορίας ΙΙ/ΙΙΙ κατά ΝΥΗΑ σε πρόγραμμα FES ή sham διέγερσης 6 εβδομάδων. Μετρήσαμε τα επίπεδα των VEGF-A, EPCs και CD34+ κυττάρων αρχικά και μετά την θεραπεία σε συνδυασμό με κλινικούς, λειτουργικούς και βιοχημικούς δείκτες.Αποτελέσματα: Τα αρχικά δημογραφικά, οι μετρήσεις σοβαρότητας της ΚΑ (κατηγοριοποίηση κατά NYHA, LVEF, BNP, λόγος Ε/Ε΄) και οι επιλεγμένοι δείκτες αγγειογένεσης (VEGF-A, CD34+ κύτταρα) δεν διέφεραν σημαντικά μεταξύ των δύο ομάδων, εκτός από τα EPCs, τα οποία ήταν λιγότερα στην ομάδα FES (p=0.003).H FES προκάλεσε σημαντικά μεγαλύτερη αύξηση στα επίπεδα των VEGF-A [∆-VEGF-A, 98.7pg/mL (21.6), στην ομάδα FES έναντι 3.1pg/mL (12.5), στην ομάδα της sham διέγερσης, p=0.002], ενώ υπήρξε μια τάση μεγαλύτερης αύξησης των EPCs στην ομάδα FES σε σχέση με την ομάδα sham [5.3% of CD34+ (1.4) έναντι 0.1 (0.8), p=0.092] και των CD34+ κυττάρων στην ομάδα FES [2572.7 cells/mL (1119.70] σε σχέση με μια σημαντική πτώση των αντίστοιχων επιπέδων στην ομάδα sham [-852.9 (1278.6), p=0.060]. Εξάλλου, η FES βελτίωσε σημαντική την κατηγοριοποίηση κατά NYHA (p<0.001), την διανυθείσα απόσταση κατά την δοκιμασία βάδισης των 6 λεπτών (6-minute walking distance, p<0.001), τα επίπεδα του BNP (p<0.001), ενώ μείωσε σημαντικά και τον λόγο Ε/Ε΄(p<0.001). Οι μεταβολές των VEGF-A και των EPCs συσχετίστηκαν με στατιστικά σημαντικό τρόπο με την 6-MWD (rho=0.549, p=0.003 and rho=0.684, p<0.001, αντίστοιχα) καθώς και η μεταβολή των CD34+ κυττάρων τόσο με τη μεταβολή της 6MWD (rho=0.648, p<0.001) όσο και με τη μεταβολή του λόγου Ε/Ε΄(rho=-0.597, p=0.001). Συμπέρασμα: Η FES φαίνεται ότι επάγει την έκφραση των VEGF-A και κινητοποιεί τα CD34+ κύτταρα και τα EPCs σε συνδυασμό με βελτίωση της λειτουργικής ικανότητας και αιμοδυναμικών παραμέτρων σε ασθενείς με ΚΑ με χαμηλό LVEF.

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Fibroblast growth factor-23 is independently associated with the left ventricular mass index in hemodialysis patients

Kasr Al Ainy Medical Journal ◽

10.4103/kamj.kamj_16_18 ◽

2018 ◽

Vol 24 (3) ◽

pp. 122

Author(s):

BahieE.A Ahmad ◽

HosnyW Mohamad ◽

Gaber Noha

Keyword(s):

Growth Factor ◽

Fibroblast Growth Factor ◽

Left Ventricular Mass ◽

Left Ventricular Mass Index ◽

Fibroblast Growth Factor 23 ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Fibroblast Growth ◽

Ventricular Mass Index ◽

Ventricular Mass

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Abstract 9902: Serum FGF23 Concentration is Associated With Cardiac Hypertrophy and Decreased Systolic Function Among Both CKD and Non-CKD Cardiac Patients

Circulation ◽

10.1161/circ.130.suppl_2.9902 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Hideaki Morita ◽

Shuichi Fujita ◽

Takahide Ito ◽

Koichi Sohmiya ◽

Masaaki Hoshiga ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Cardiac Hypertrophy ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Cardiac Patients ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Fgf23 Concentration ◽

Independent Variable

Introduction: Purpose: Serum concentrations of fibroblast growth factor-23 (FGF23) are increased in response to elevated serum phosphate levels among patients with renal dysfunction. Besides regulating circulating phosphate levels, FGF23 may induce cardiac hypertrophy; thus, enhanced FGF23 excretion may underlie the heart failure observed among patients with chronic kidney disease (CKD). Here we examined whether FGF23 concentrations are associated with cardiac hypertrophy among cardiac patients regardless of the presence or absence of CKD. Methods: The present study enrolled 480 cardiac patients admitted to our cardiology department between January 2012 and December 2012. Serum FGF23 level was measured by an ELISA method. Left ventricular mass index (LVMI) was used as a marker of cardiac hypertrophy. Results: Of the 480 patients, 132 (27.5%) had an estimated glomerular filtration rate (eGFR) of <60 mL/min/m2 (no-CKD group) and the remaining 348 (72.5%) had an eGFR of 60 or greater (CKD group). FGF23 was correlated with eGFR in the CKD group, but not in the no-CKD group. Stepwise multivariate linear regression analysis was performed using LVMI as a dependent variable, and sex, age, eGFR, serum calcium and phosphate, and log(FGF23) as independent variables. Log(FGF23) was selected as an independent variable that had a significant association with LVMI with a standardized correlation coefficient of 0.26 in the no-CKD group (P<0.01) and 0.25 in the CKD group (P<0.01). When left ventricular ejection fraction was used as an independent variable in this model, log(FGF23) was selected as significant predictor with a standardized correlation coefficient of -0.20 in the no-CKD group (P<0.05) and -0.18 in the CKD group (P<0.01). Conclusions: Among cardiac patients, serum FGF23 concentration was associated positively with left ventricular mass and negatively with left ventricular ejection fraction not only in patients with CKD, but also in those without CKD.

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