Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Arterial Stiffness Due to Phosphate Retention Is an Important Predictor of Heart Failure With Preserved Ejection Fraction (HFpEF)

Version 1 : Received: 17 April 2024 / Approved: 17 April 2024 / Online: 17 April 2024 (17:05:07 CEST)

A peer-reviewed article of this Preprint also exists.

Mizuno, Y.; Ishida, T.; Tsujita, K.; Yoshimura, M. Arterial Stiffness Is an Important Predictor of Heart Failure with Preserved Ejection Fraction (HFpEF)—The Effects of Phosphate Retention. Hearts 2024, 5, 211-224. Mizuno, Y.; Ishida, T.; Tsujita, K.; Yoshimura, M. Arterial Stiffness Is an Important Predictor of Heart Failure with Preserved Ejection Fraction (HFpEF)—The Effects of Phosphate Retention. Hearts 2024, 5, 211-224.

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is a major health concern. There is a growing recognition of the causal interplay between arterial stiffness and HFpEF. We recently reported that phosphate retention is a trigger for arterial stiffness. This study focuses on whether arterial stiffness due to phosphate retention could be a predictor for HFpEF. Methods: The study subjects were 158 patients (68 males and 90 females, mean age 74.8±11.2). HFpEF was defined according to the guidelines of the ESC 2019. Pulse wave velocity (PWV) and central systolic blood pressure (CSBP) were used as markers for arterial stiffness and afterload, respectively. We measured serum levels of fibroblast growth factor 23 (FGF23) as a marker of phosphate retention. Results: The serum levels of FGF23 had significant relationship with PWV. PWV had significant relationships with LV mass index, plasma BNP levels, and relative wall thickness, e’ and E/e’ (p<0.001, respectively). Multivariate logistic regression analysis revealed that PWV higher values and hypertension were significant predictors for the dependent factor (HFpEF). Conclusions: Arterial stiffness amplified LV afterload, leading to LV concentric hypertrophy and LV diastolic dysfunction. This study presents that arterial stiffness due to phosphate retention, and hypertension are important predictors of HFpEF.

Keywords

HFpEF; Arterial Stiffness; Phosphate; FGF23; PWV; afterload; BNP

Subject

Physical Sciences, Biophysics

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