- \(\bf Background\)
Calcium and phosphate are central for myocardial contractility and energy metabolism, and low levels of the calciotropic hormone 1,25-dihydroxyvitamin D \((1,25(OH)_{2}D)\), as well as high levels of the phosphaturic hormone fibroblast growth
factor (FGF)-23, are independently associated with poor clinical outcome in heart failure (HF) patients. We therefore aimed to investigate the postoperative time course of the aforementioned hormones in HF patients supported with a left-ventricular assist
device (LVAD) implant.
\(\bf Methods\)
For the present study, stored biobank plasma samples of 69 patients, collected before LVAD implantation (t0) and 12 days (t1), 30 days (t2), 83 days (t3), and 300 days (t4) post-intervention, were used to measure circulating FGF-23, parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), \(1,25(OH)_{2}D\), and kidney function.
\(\bf Results\)
Most patients were male and had baseline INTERMACS levels and cardiac index values \(\leq\) 3 and \(\leq\) 2.7 \(L/min/m^{2}\), respectively. There were significant time effects on estimated glomerular filtration rate (eGFR), FGF-23 and
\(1,25(OH)_{2}D\), but not on PTH or 25OHD. Notably, eGFR values increased and FGF-23 levels decreased only transiently, whereas \(1,25(OH)_{2}D\) increased continuously until t4. The rise in \(1,25(OH)_{2}D\) was largely influenced by those patients who survived the first post-implant year, and was not seen in non-survivors. Variations in \(1,25(OH)_{2}D\) levels could only partly be explained by eGFR values or FGF-23, 25OHD, and PTH levels (multiple \(R^{2}\) = 0.305;P<0.001).
\(\bf Conclusions\)
The present study indicates that LVAD implantation has only transient effects on circulating FGF-23 levels, but is associated with a continuous increase in circulating \(1,25(OH)_{2}D\) levels, especially in survivors.
MetadatenAuthor: | Armin ZittermannORCiDGND, Jana Barbara ErnstGND, Stefan PilzGND, Jens DreierGND, Joachim KuhnGND, Cornelius KnabbeGND, Jan GummertORCiDGND, Michiel MorshuisORCiDGND, Hendrik MiltingORCiDGND |
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URN: | urn:nbn:de:hbz:294-58470 |
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DOI: | https://doi.org/10.1371/journal.pone.0164459 |
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Parent Title (English): | PLoS one |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2018/07/05 |
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Date of first Publication: | 2016/10/27 |
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Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
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Tag: | Open Access Fonds |
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Volume: | 11 |
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Issue: | 10 |
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First Page: | e0164459-1 |
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Last Page: | e0164459-10 |
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Note: | Article Processing Charge funded by the Open Access Publication Fund of Ruhr-Universität Bochum. |
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Note: | PLoS ONE, Bd. 11, H. 10, Artikelnummer e0164459 |
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Institutes/Facilities: | Herz- und Diabeteszentrum NRW, Klinik für Thorax- und Kardiovaskularchirurgie |
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Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
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open_access (DINI-Set): | open_access |
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faculties: | Medizinische Fakultät |
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Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |
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