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01.10.2013 | Original Article

Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure

verfasst von: Tamara Isakova, Jessica Houston, Laura Santacruz, Eva Schiavenato, Gabriel Somarriba, William G. Harmon, Steven E. Lipshultz, Tracie L. Miller, Paolo G. Rusconi

Erschienen in: Pediatric Nephrology | Ausgabe 10/2013

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Abstract

Background

In adults with heart failure, elevated levels of fibroblast growth factor 23 (FGF23) are associated with mortality. Data on FGF23 levels in pediatric heart failure are lacking.

Patients and methods

We conducted a cross-sectional study of 17 healthy children (mean age 13 years) and 20 pediatric patients with heart failure (mean age 12 years) who underwent echocardiography and for whom the following measurements were taken: plasma FGF23 and parathyroid hormone (PTH) and serum phosphate, creatinine and N-terminal prohormone brain natriuretic peptide (NT-proBNP). Symptom severity was assessed with the New York Heart Association and the Ross classification systems.

Results

Of the 20 patients, 11 had dilated cardiomyopathy, four had congenital heart disease, three had hypertrophic cardiomyopathy, one had a failing heart transplant and one had pulmonary hypertension. Mean phosphate levels in these patients were within the reported reference range for healthy children. Median PTH levels were in the normal range in patients and controls. The median FGF23 level was higher in patients versus controls (110.9 vs. 66.4 RU/ml; P = 0.03) and higher in patients on diuretics versus other patients (222.4 vs. 82.1 RU/ml; P = 0.01). Levels of FGF23 and NT-proBNP were directly correlated (r = 0.47, P = 0.04), and patients with greater physical functional impairment had higher FGF23 levels (142.5 in those with moderate-severe limitation vs. 92.8 RU/ml in those with no limitation; P = 0.05). Among patients with dilated cardiomyopathy, higher FGF23 levels were associated with a greater left ventricular end-diastolic diameter (r = 0.63, P = 0.04).

Conclusion

FGF23 levels are elevated in children with heart failure and are associated with diuretic use, severity of heart failure and left ventricular dilation.

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Titel: Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure
verfasst von: Tamara Isakova
Jessica Houston
Laura Santacruz
Eva Schiavenato
Gabriel Somarriba
William G. Harmon
Steven E. Lipshultz
Tracie L. Miller
Paolo G. Rusconi
Publikationsdatum: 01.10.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 10/2013
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-013-2515-7

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Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure

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Background

Patients and methods

Results

Conclusion

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