FGF-23 is a biomarker of RV dysfunction and congestion in patients with HFrEF.

0579894 - ÚMG 2024 RIV US eng J - Journal Article
Beneš, J. - Kroupová, K. - Kotrc, M. - Petrák, J. - Jarolim, P. - Novosadová, Vendula - Kautzner, J. - Melenovský, V.
FGF-23 is a biomarker of RV dysfunction and congestion in patients with HFrEF.
Scientific Reports. Roč. 13, č. 1 (2023), č. článku 16004. ISSN 2045-2322. E-ISSN 2045-2322
R&D Projects: GA MŠMT LX22NPO5102
Institutional support: RVO:68378050
Keywords : biomarker * RV dysfunction * cardiovascular medicine
OECD category: Biochemistry and molecular biology
Impact factor: 4.6, year: 2022
Method of publishing: Open access
https://www.nature.com/articles/s41598-023-42558-4

There is no biomarker reflecting right ventricular dysfunction in HFrEF patients used in clinical practice. We have aimed to look for a circulating marker of RV dysfunction employing a quantitative proteomic strategy. The Olink Proteomics Multiplex panels (Cardiovascular Disease II, III, Cardiometabolic, and Inflammation Target Panels) identified FGF-23 to be the most differentially abundant (more than 2.5-fold) in blood plasma of HF patients with severe RV dysfunction (n=30) compared to those with preserved RV function (n=31). A subsequent ELISA-based confirmatory analysis of circulating FGF-23 in a large cohort of patients (n=344, 72.7% NYHA III/IV, LVEF 22.5%, 54.1% with moderate/severe RV dysfunction), followed by multivariable regression analysis, revealed that the plasma FGF-23 level was most significantly associated with RV dysfunction grade (p=0.0004) and congestion in the systemic circulation (p=0.03), but not with LV-ejection fraction (p=0.69) or estimated glomerular filtration rate (eGFR, p=0.08). FGF-23 was associated with the degree of RV dysfunction in both sub-cohorts (i.e. in patients with and without congestion, p<0.0001). The association between FGF-23 and RV-dysfunction remained significant after the adjustment for BNP (p=0.01). In contrast, when adjusted for BNP, FGF-23 was no longer associated with LV dysfunction (p=0.59). The Cox proportional hazard model revealed that circulating FGF-23 was significantly associated with adverse outcomes even after adjusting for BNP, LVEF, RV dysfunction grade and eGFR. Circulating FGF-23 isthus a biomarker of right ventricular dysfunction in HFrEF patients regardless of congestion status.
Permanent Link: https://hdl.handle.net/11104/0348679