TY - JOUR
T1 - Relations of serum phosphorus levels to echocardiographic left ventricular mass and incidence of heart failure in the community
AU - Dhingra, Ravi
AU - Gona, Philimon
AU - Benjamin, Emelia J.
AU - Wang, Thomas J.
AU - Aragam, Jayashri
AU - D'Agostino, Ralph B.
AU - Kannel, William B.
AU - Vasan, Ramachandran S.
PY - 2010/8
Y1 - 2010/8
N2 - Aims To evaluate the association of serum phosphorus with cardiac structure/function and incident heart failure.Methods and resultsWe related serum phosphorus to echocardiographic left ventricular (LV) measurements cross-sectionally, and to incident 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 analyses 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.ConclusionIn our community-based sample, higher serum phosphorus was associated with greater LV mass cross-sectionally, and with an increased risk of heart failure prospectively.
AB - Aims To evaluate the association of serum phosphorus with cardiac structure/function and incident heart failure.Methods and resultsWe related serum phosphorus to echocardiographic left ventricular (LV) measurements cross-sectionally, and to incident 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 analyses 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.ConclusionIn our community-based sample, higher serum phosphorus was associated with greater LV mass cross-sectionally, and with an increased risk of heart failure prospectively.
KW - Congestive heart failure
KW - Epidemiology
KW - Phosphorus
KW - Risk factors
KW - Ventricle
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U2 - 10.1093/eurjhf/hfq106
DO - 10.1093/eurjhf/hfq106
M3 - Article
C2 - 20675668
AN - SCOPUS:77955448555
SN - 1388-9842
VL - 12
SP - 812
EP - 818
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 8
ER -