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Abstract: FR-PO363

Fibroblast Growth Factor 23 Is Associated with Biomarkers of Cardiomyocyte Stress/Injury in Patients with CKD

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Coloma, Ana, Hospital San Pedro, Logroño, Spain
  • Azcarate, Pedro, Hospital San Pedro, Logroño, Spain
  • Valdivielso, Jose M., IRBLLEIDA, Lleida, Spain
  • Ramalle-Gomara, Enrique, La Rioja Regional Authority - Logroño - Spain, Logroño, Spain
  • Loza, Emma Huarte, Hospital San Pedro, Logroño, Barcelona, Spain
  • Diez, Javier, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain
Background

High levels of fibroblast growth factor 23 (FGF23) has been related with left ventricular hypertrophy (LVH) in adults with CKD. In this cross-sectional study, we aimed to determinate the associations between c-terminal FGF23 (ctFGF23), intact FGF23 (iFGF23), serum αKlotho, cystatin C, high sensitive troponin T (hsTnT), prothormone brain natriuretic peptide (NT-proBNP) levels and structural and functional cardiac changes in patients with chronic kidney disease (CKD).

Methods

We enrolled patients with CKD and left ventricular ejection fraction (LVEF) >50%. Patients with atrial fibrillation, history of heart failure, myocardial infarction, pulmonary hypertension, cardiomyopathies, LVEF <50% or parathyroidectomy were excluded. Laboratory parameters including serum creatinine, 24h-proteinuria, mineral bone disorder (calcium, parathormone (PTH), phosphate, tubular reabsorption of phosphate (TRP), phosphate clearance), iFGF23, ctFGF23, serum αklotho, hs-TnT, NT-proBNP were measured. Echocardiographic parameters including LV mass index, relative wall thickness (RWT), volume end-diastolic (VTD), early diastolic mitral annulus velocity (e’ velocity), E/e’, left atrial volume index (LAVI) and global longitudinal strain (GLS) were measured by the same cardiologist at the same day of blood extraction. The cardiologist was blind for the stage of CKD in each patient.

Results

120 patients were included. FGF23 was related with 2 biomarkers of cardiomyocyte stress/injury: hsTnT (p<0.05) and NT-proBNP (p<0.05), without finding an association with structural and functional cardiac parameters. However, cystatin C, hsTnT and NT-proBNP were associated with LV mass (p<0.05), RWT (p<0.001), VTD (p<0.001), e’velocity (p<0.001), E/e’ (p<0.001), LAVI (p<0.001). We also found that FGF23 was associated with αKlotho (p<0.05), creatinine based-estimated glomerular filtration rate (p<0.001), 24h proteinuria (p<0.001), cystatin C (p<0.001), PTH (p<0.001), TRP (p<0.05).

Conclusion

FGF23 was not associated with structural and functional cardiac changes, but it was associated with two biomarkers of cardiomyocyte stress/injury: hsTnT and NT-proBNP. This finding suggests a relation between FGF23 and remodeling of cardiac tissue in patients with chronic kidney disease.

Funding

  • Government Support - Non-U.S.