title: Association between circulating FGF23, α-Klotho, and left ventricular diastolic dysfunction among patients with preserved ejection fraction.
abstract: Besides regulating calcium-phosphate metabolism, fibroblast growth factor-23 (FGF23) and Klotho have been proposed to have other roles in heart and vasculature. For example, FGF23 has been associated with cardiac hypertrophy and reduced left ventricular ejection fraction among patients with chronic kidney disease and cardiovascular disorders. The purpose of the study was to investigate whether serum FGF23 and α-Klotho concentrations are associated with cardiac diastolic dysfunction and related parameters among cardiac patients with preserved left ventricular ejection fraction. The current study enrolled 269 patients (69 women, 200 men) who were admitted to our cardiology department between October 2012 and January 2014 and had a left ventricular ejection fraction of >50%. Cardiac diastolic function was assessed by blood flow and tissue Doppler velocities, plasma B-type natriuretic peptide (BNP) concentration, and cardiac hypertrophy. After adjusting for sex, and age, logistic regression analysis showed that log(α-Klotho), but not log(FGF23), was significantly associated with diastolic dysfunction. After further adjustment for renal function, blood hemoglobin, and serum albumin levels, the negative association between log(α-Klotho) and diastolic dysfunction retained statistical significance with an odds ratio of 0.50 (95% confidence interval 0.31-0.81, P = 0.005, per 1 standard deviation). Among patients with preserved LVEF, serum α-Klotho concentrations were negatively associated with diastolic dysfunction. Whether modulation of serum levels α-Klotho will ameliorate cardiac diastolic function among patients with this disorder awaits further investigation.
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Fujita
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Morita
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kizawa
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Sakane
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sohmiya
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hoshiga
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. nobuishizka-tky@umin.ac.jp.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood; D015150:Echocardiography, Doppler; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005919:Glomerular Filtration Rate; D005966:Glucuronidase / Q000097:blood*; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D007564:Japan; D000090265:Klotho Proteins; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000097:blood; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood*
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D020097:Natriuretic Peptide, Brain; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D005966:Glucuronidase; D000090265:Klotho Proteins
keywords: Diastolic dysfunction; Fibroblast growth factor-23; Klotho; Preserved ejection fraction