Study Of Fibroblast Growth Factor 23, Klotho,and Ventricular Remodeling In Patients With Chronic Heart Failure

Objective:The aim of this study is to investigate the change of serum FGF23、Klotho concentration in patients with chronic heart failure and explore the relationships of FGF23、Klotho and left ventricular remodeling in chronic heart failure.Methods:Chose the patients who were hospitalized in the geriatric departtment and cardiovascular department of the Yi Ji Shan Hospital from Dec 2013 to June 2014,which were diagonosed as the Chronic heart failure.Grading standards according to New York Heart Association(NYHA classification).NYHA Class II patients were rejected.The number of NYHA Class III patients was 105 cases,then the NYHA Class IV had 104 cases.Recorded the selected patients’ age,gender, family history and other factors which may influence the development of chronic heart failure.All enrolled patients carried on the routine measurement of height, weight, blood pressure, heart rate and other basic indicators collected after admission.Blood samples were collected early in the morning of the second day under fasting conditions,separated serum and plasma partly, 1ml serum will be placed in freezing tube, deposit insurance to-80 degrees centigrade.The concentration of FGF23 and Klotho was detected by ELISA, namely the enzyme linked immunosorbent assay.Recording in patients with clinical data including blood routine, biochemical indexes of liver and renal function, and cardiac ultrasound determination of interventricular septal thickness(IVSd) and other parameters reflecting the ventricular remodeling, left ventricular mass index was calculated according to theformula.After the correction of interference factors, using statistical package to analysis and process all data.Results: 1)The hemoglobin, uric acid, NT-BNP, HDL, LDL, Na, LVEF, LVMI of the NYHA Class IV group have obvious change(P<0.05), There were no significant difference between the two groups in gender, height, weight, blood pressure, heart rate, blood routine and other biochemical indicators(P>0.05).2) Serum FGF23 concentration in the NYHA Class IV group(855.28± 338.94ng/L) was significantly higher than NYHA Class III group(742.29±213.45ng/L)(P<0.05).Serum FGF23 concentration was positively correlated with LVMI、LVDd、IVSd、PWT,r(LVMI) =0.237, r(LVDd) =0.163, r(IVSd) =0.241, r(PWT) =0.194, P <0.05, and negatively correlated with left ventricular ejection fraction(r=-0.171, P<0.05).3)The serum Klotho concentration in NYHA Class III group(42.99 + 8.26) U/L, has no obvious difference with NYHA Class IV group(43.75 + 7.77U/L). The correlation coefficient between serum Klotho concentration and left ventricular ejection fraction, left ventricular mass index, left ventricular end diastolic diameter, interventricular septum thickness, left ventricular posterior wall thickness were-0.014, 0.090,-0.024, 0.111, 0.119, respectively,P >0.05, has no obvious correlation.Conclusion: In the patients with chronic heart failure enrolled, the serum FGF23 concentration was significantly higher than the NYHA Class III group. Serum FGF23 concentration has positive correlation with the extent of ventricular remodeling in chronic heart failure.FGF23 may can be used as biological indicator to evaluate the degree of chronic heart failure ventricular remodeling.