Abstract
Background
Heart failure with preserved ejection fraction (HFpEF) is characterized by left ventricular
hypertrophy and decreased exercise capacity. Fibroblast growth factor 23 (FGF23),
a hormone involved in phosphate, vitamin D, and iron homeostasis, is linked to left
ventricular hypertrophy and HF. We measured c-terminal FGF23 (cFGF23) and intact FGF23
(iFGF23) levels and examined their associations with exercise capacity in patients
with HFpEF.
Methods and Results
Using multivariable linear regression and linear mixed models, we studied the associations
of cFGF23 and iFGF23 with baseline and mean weekly change over 24 weeks in peak oxygen
consumption and 6-minute walk distance in individuals enrolled in the Phosphodiesterase-5
Inhibition to Improve Clinical Status and Exercise Capacity in HFpEF trial. Our study
population included 172 individuals with available plasma for cFGF23 and iFGF23 measurements.
Median (25th–75th percentile) baseline cFGF23 and iFGF23 levels were 208.7 RU/mL (132.1–379.5
RU/mL) and 90.3 pg/mL (68.6–128.5 pg/mL), respectively. After adjustment for cardiovascular
disease and hematologic and kidney parameters, higher cFGF23 was independently associated
with a lower peak oxygen consumption at baseline. Higher iFGF23 was independently
associated with shorter 6-minute walk distance at baseline. No significant associations
were appreciated with the longitudinal outcomes.
Conclusions
In patients with HFpEF, higher FGF23 levels are independently associated with decreased
exercise capacity at baseline.
Graphical abstract
Graphical Abstract
Key Words
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Article info
Publication history
Published online: October 06, 2020
Accepted:
September 25,
2020
Received in revised form:
August 24,
2020
Received:
May 18,
2020
Identification
Copyright
Published by Elsevier Inc.
