Relations of serum phosphorus levels to echocardiographic left ventricular mass and incidence of heart failure in the community

Autor: Philimon Gona, Jayashri Aragam, Emelia J. Benjamin, Ramachandran S. Vasan, Ralph B. D'Agostino, Ravi Dhingra, Thomas J. Wang, William B. Kannel
Rok vydání: 2010
Předmět:
Zdroj: European Journal of Heart Failure. 12:812-818
ISSN: 1879-0844
1388-9842
DOI: 10.1093/eurjhf/hfq106
Popis: To evaluate the association of serum phosphorus with cardiac structure/function and incident heart failure. Methods We related serum phosphorus to echocardiographic left ventricular (LV) measurements cross-sectionally, and to inci- dent heart failure prospectively in 3300 participants (mean age 44 years, 51% women) free of heart failure, myocardial infarction, and chronic kidney disease (estimated glomerular filtration rate (eGFR),60 mL/min/1.73 m 2 ). Cross- sectionally, serum phosphorus was related positively to LV mass, internal dimensions, and systolic dysfunction. On follow-up (mean 17.4 years), 157 individuals developed heart failure. In models adjusting for established risk factors as time-varying covariates, each mg/dL increment in serum phosphorus was associated with a 1.74-fold risk of heart failure (95% confidence intervals (CI) 1.17-2.59). Individuals in the highest serum phosphorus quartile experienced a two-fold (95% CI 1.28-3.40) risk of heart failure compared with participants in the lowest quartile. These relations were maintained upon additional adjustment for LV mass/dimensions and systolic dysfunction. In ana- lyses restricted to individuals with eGFR .90 mL/min/1.73 m 2 , no proteinuria and serum phosphorus ,4.5 mg/dL, the association of serum phosphorus with heart failure remained robust. Conclusion In our community-based sample, higher serum phosphorus was associated with greater LV mass cross-sectionally, and with an increased risk of heart failure prospectively.
Databáze: OpenAIRE