Pos1274 fgf23 and cardiovascular structure in women with systemic sclerosis

Background Systemic sclerosis (SSc), an autoimmune disease characterized by fibrosis of the skin and various internal organs, is associated with cardiovascular abnormalities including pulmonary hypertension, atherosclerosis, right and left ventricular dysfunction, arrhythmias, conduction defects, pericardial disease, and valvular heart disease. Fibroblast growth factor-23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and has been implicated as a putative pathogenic factor in cardiovascular disease. FGF23 has been associated with cardiac hypertrophy and reduced left ventricular ejection fraction among patients with chronic kidney disease and cardiovascular disorders. Objectives The aim of this study was to examine the possible association between serum FGF23 levels and echocardiographic abnormalities in women with SSc. Methods This cross-sectional study was performed in San Cecilio Hospital, Granada (Spain) from November 2017 to May 2019. Sixty-two women with SSc were enrolled in this study. All patients included in this study had normal serum creatinine (Cr) levels and met the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for SSc. Echocardiograms were performed at a single clinical site using Philips ie33 ultrasound machine with subjects in the left lateral decubitus position. Serum FGF23 was analyzed using ELISA. Results A total of 62 female patients were included in our study, with a mean (SD) age of 53 ± 10 years. The majority were Caucasian (90.5%). The mean disease duration was 8.8 ± 6.9 years. Forty-four (70.9%) patients had a limited form of the disease and 18 (29.1%) had a diffuse form. The mean left ventricular posterior wall thickness and left ventricular systolic diameter were 8.1±1.3 mm and 25.3±4.8 mm, respectively. We found a statistically significant inverse relationship between FGF23 and posterior wall thickness (r= -0.34; p= 0.03) and a statistically significant relationship between FGF23 and left ventricular systolic diameter (r= 0.5; p= 0.03) in women with SSc. Furthermore, in the linear regression model, lower FGF23 concentrations were associated with greater posterior wall thickness [β = -15.11 95% CI (-29.38, -0.848); p < 0.05]. Conclusion We report an association between circulating FGF23 and left ventricular posterior wall thickness in SSc female patients, representing a novel pathway linking FGF23 to an increased cardiovascular risk. References [1]Ho M, Veale D, Eastmond C, et al. Macrovascular disease and systemic sclerosis. Ann Rheum Dis. 2000; 59(1):39–43. [2]Mani P, Gonzalez D, Chatterjee S, Faulx MD. Cardiovascular complications of systemic sclerosis: What to look for. Cleve Clin J Med. 2019 Oct;86(10):685-695. [3]Okamoto Y, Fujita S, Morita H, Kizawa S, Ito T, Sakane K, Sohmiya K, Hoshiga M, Ishizaka N. Association between circulating FGF23, α-Klotho, and left ventricular diastolic dysfunction among patients with preserved ejection fraction. Heart Vessels. 2016 Jan;31(1):66-73. [4]Halim A, Burney HN, Li X, Li Y, Tomkins C, Siedlecki AM, Lu TS, Kalim S, Thadhani R, Moe S, Ting SMS, Zehnder D, Hiemstra TF, Lim K. FGF23 and Cardiovascular Structure and Function in Advanced Chronic Kidney Disease. Kidney360. 2022 Jul 5;3(9):1529-1541. Acknowledgements: NIL. Disclosure of Interests None Declared.