The Klotho Deficiency and Not the FGF-23 Rise Is Associated with Heart Failure with Reduced Left Ventricular Ejection Fraction in Patients with Preserved Kidney Function

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Background: The FGF23-Klotho axis is increasingly implicated in the pathophysiology of heart failure, especially during advanced chronic kidney disease (CKD). Our objective is to study the association between this FGF23-Khloto axis and heart failure in patients without CKD. This topic is less studied in medical literature Methods: This is a cross-sectional study of the FGF23 assessment, Klotho and the rest of the phosphocalcic assessment covering 70 patients with normal renal function. These patients had echocardiographic exploration which made it possible to distribute them in two groups: Group HF: LVEF(Left Ventricular Ejection Fraction)<55% (n = 18); Group NoHF: LVEF> 55% (n = 52). Heart failure(HF) was exclusively of ischemic origin. Results: These were 36 women and 34 men, average age 58 + - 10 years with an estimated glomerular filtration rate (eGFR) at an average of 92 ml / min / 1.73m2. No difference in eGFR between the two groups. Klotho was far lower with a statistically significant difference in Group HF. FGF23 was higher in Group HF but the difference was not statistically significant. PTH (parathyroid hormone)was statistically higher in Group HF and calcemia was statistically lower in Group HF. Phosphatemia and vitamin D were not associated with heart failure. Conclusions: Although the sample studied is not large, Klotho but not FGF23 is strongly associated with systolic heart failure. This and other results will be further discussed.

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