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

Ravi Dhingra, Philimon Gona, Emelia J. Benjamin, Thomas J. Wang, Jayashri Aragam, Ralph B. D'Agostino, William B. Kannel, Ramachandran S. Vasan

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)812-818
Number of pages7
JournalEuropean Journal of Heart Failure
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2010
Externally publishedYes

Keywords

  • Congestive heart failure
  • Epidemiology
  • Phosphorus
  • Risk factors
  • Ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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