title: Circulating Fibroblast Growth Factor 21 is Associated with Diastolic Dysfunction in Heart Failure Patients with Preserved Ejection Fraction.
abstract: Fibroblast growth factor 21 (FGF21), a polypeptide ligand promoted glucose homeostasis and lipids metabolism, was recently reported to attenuate cardiac hypertrophy. The aim of this study was to investigate the impact of FGF21 in diastolic heart failure. Subjects admitted for coronary angiogram were screened for heart failure, and those with left ventricular (LV) ejection fraction < 45% were excluded. Diastolic dysfunction was defined as functional abnormalities that exist during LV relaxation and filling by echocardiographic criteria. Plasma levels of FGF21 and N-terminal Pro-Brain Natriuretic Peptide (NT-pro-BNP) were determined. All patients were followed up for 1 year, or till the occurrence of heart failure readmission or death. Totally 95 patients with diastolic dysfunction and 143 controls were enrolled. Circulating FGF21 level was correlated with echocardiographic parameters of diastolic function and LV end-diastolic pressure (LVEDP). In multivariate logistic analysis, FGF21 was significantly associated with diastolic dysfunction, either identified by echocardiographic criteria (odds ratio: 2.97, p = 0.012) or confirmed with LVEDP level (odds ratio: 3.73, p = 0.030). Both plasma FGF21 (log rank p < 0.0001) and NT-pro-BNP levels (log rank p = 0.0057) showed good predictive power to the 1-year adverse cardiac events. This finding suggested FGF21 could be involved in the pathophysiology of diastolic heart failure.
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, 11217, Taiwan.
authors.forename: Ruey-Hsing
authors.initials: RH
authors.lastname: Chou
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, 11217, Taiwan.
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.affiliation: Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, 11217, Taiwan.|Department of Internal Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.|Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, 11031, Taiwan.
authors.forename: Chien-Yi
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, 11217, Taiwan.
authors.forename: Chun-Chin
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, 11217, Taiwan.|Healthcare and Management Center Taipei Veterans General Hospital, Taipei, 11217, Taiwan.
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Department of Medical Education Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Pharmacology, National Yang-Ming University, Taipei, 11217, Taiwan.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Pharmacology, National Yang-Ming University, Taipei, 11217, Taiwan.|Department of Medical Research Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Division of Clinical Research Taipei Veterans General Hospital, Taipei, 11217, Taiwan.
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Medicine Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Cardiovascular Research Center, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, 11217, Taiwan.|Department of Internal Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.|Department of Medical Research Taipei Veterans General Hospital, Taipei, 11217, Taiwan.
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood*; D005500:Follow-Up Studies; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D013318:Stroke Volume
chemical_list: D010446:Peptide Fragments; C414620:fibroblast growth factor 21; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D005346:Fibroblast Growth Factors