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

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

Research output: Contribution to journalArticle

21 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)2035-2042
Number of pages8
JournalPediatric Nephrology
Volume28
Issue number10
DOIs
StatePublished - Oct 1 2013

Fingerprint

Heart Failure
Pediatrics
Brain Natriuretic Peptide
Dilated Cardiomyopathy
Parathyroid Hormone
Diuretics
Reference Values
Phosphates
fibroblast growth factor 23
Hypertrophic Cardiomyopathy
Pulmonary Hypertension
Echocardiography
Dilatation
Heart Diseases
Creatinine
Cross-Sectional Studies
Transplants
Mortality
Serum

Keywords

  • Diuretics
  • Fibroblast growth factor 23
  • Heart failure
  • N-terminal prohormone brain natriuretic peptide
  • Parathyroid hormone

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure. / Isakova, Tamara; Houston, Jessica; Santacruz, Laura; Schiavenato, Eva; Somarriba, Gabriel; Harmon, William G.; Lipshultz, Steven E; Miller, Tracie L; Rusconi, Paolo.

In: Pediatric Nephrology, Vol. 28, No. 10, 01.10.2013, p. 2035-2042.

Research output: Contribution to journalArticle

Isakova, T, Houston, J, Santacruz, L, Schiavenato, E, Somarriba, G, Harmon, WG, Lipshultz, SE, Miller, TL & Rusconi, P 2013, 'Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure', Pediatric Nephrology, vol. 28, no. 10, pp. 2035-2042. https://doi.org/10.1007/s00467-013-2515-7
Isakova T, Houston J, Santacruz L, Schiavenato E, Somarriba G, Harmon WG et al. Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure. Pediatric Nephrology. 2013 Oct 1;28(10):2035-2042. https://doi.org/10.1007/s00467-013-2515-7
Isakova, Tamara ; Houston, Jessica ; Santacruz, Laura ; Schiavenato, Eva ; Somarriba, Gabriel ; Harmon, William G. ; Lipshultz, Steven E ; Miller, Tracie L ; Rusconi, Paolo. / Associations between fibroblast growth factor 23 and cardiac characteristics in pediatric heart failure. In: Pediatric Nephrology. 2013 ; Vol. 28, No. 10. pp. 2035-2042.
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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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AU - Isakova, Tamara

AU - Houston, Jessica

AU - Santacruz, Laura

AU - Schiavenato, Eva

AU - Somarriba, Gabriel

AU - Harmon, William G.

AU - Lipshultz, Steven E

AU - Miller, Tracie L

AU - Rusconi, Paolo

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AB - 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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KW - Parathyroid hormone

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