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

Dhingra R, Gona P, Benjamin EJ, Wang TJ, Aragam J, D'Agostino RB, Kannel WB, Vasan RS
Eur J Heart Fail. 2010 12 (8): 812-8

PMID: 20675668 · PMCID: PMC2913049 · DOI:10.1093/eurjhf/hfq106

AIMS - To evaluate the association of serum phosphorus with cardiac structure/function and incident heart failure.

METHODS AND RESULTS - We 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.

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.

MeSH Terms (24)

Adult Computer Simulation Confidence Intervals Cross-Sectional Studies Disease Progression Echocardiography Female Glomerular Filtration Rate Heart Failure Heart Ventricles Humans Hypertrophy, Left Ventricular Incidence Logistic Models Male Multivariate Analysis Phosphorus Proportional Hazards Models Prospective Studies Residence Characteristics Risk Assessment Risk Factors Systole United States

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