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<p>Fibroblast growth factor 23 (FGF23), a bone-derived hormone, is emerging as a potential biomarker in cardiovascular disease. However, its role in transthyretin amyloid cardiomyopathy (ATTR-CM), a progressive infiltrative cardiomyopathy, remains poorly defined. This study examined the relationship between circulating FGF23 levels and cardiac and renal function markers in patients with ATTR-CM. In 114 patients with confirmed ATTR-CM, intact FGF23 levels were measured in venous ethylenediaminetetraacetic acid blood samples using a chemiluminescent immunoassay on the DiaSorin LIAISON XL system. Associations between FGF23 levels, cardiac biomarker levels, and disease severity were evaluated across FGF23 tertiles and National Amyloidosis Centre (NAC) stages. N-terminal pro–B-type natriuretic peptide (NT-proBNP) and troponin T levels were significantly associated with FGF23 tertiles. NT-proBNP medians across tertiles were 1,608, 2,920, and 1,948.5 pg/mL, respectively (<i>P</i> = 0.0084). Higher FGF23 levels were significantly associated with advanced NAC classification, and cumulative probability modeling supported its association with disease stage. After adjustment for eGFR, FGF23 remained significantly associated with NT-proBNP (Spearman’s ρ = 0.16; p = 0.084). However, the association with troponin T did not reach statistical significance (ρ = 0.19; p = 0.043), representing a non-significant trend. This is the first study to demonstrate a significant association between FGF23 and established markers of cardiac injury and disease staging in ATTR-CM, supporting FGF23 as a potential complementary biomarker for risk stratification.</p>

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Fibroblast growth factor 23 is associated with cardiac disease severity in transthyretin amyloid cardiomyopathy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月4日

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  • Mahshid Eslami,
  • Nikita Ermolaev,
  • Christina Kronberger,
  • Lena Schmid,
  • Michael Poledniczek,
  • Bernhard Gregshammer,
  • Antonio Kösters,
  • Farideh Alasti,
  • Andreas A. Kammerlander,
  • René Rettl,
  • Franz Duca,
  • Christina Binder,
  • Johannes Kastner,
  • Rodrig Marculescu,
  • Helmuth Haslacher,
  • Roza Badr Eslam

摘要

Fibroblast growth factor 23 (FGF23), a bone-derived hormone, is emerging as a potential biomarker in cardiovascular disease. However, its role in transthyretin amyloid cardiomyopathy (ATTR-CM), a progressive infiltrative cardiomyopathy, remains poorly defined. This study examined the relationship between circulating FGF23 levels and cardiac and renal function markers in patients with ATTR-CM. In 114 patients with confirmed ATTR-CM, intact FGF23 levels were measured in venous ethylenediaminetetraacetic acid blood samples using a chemiluminescent immunoassay on the DiaSorin LIAISON XL system. Associations between FGF23 levels, cardiac biomarker levels, and disease severity were evaluated across FGF23 tertiles and National Amyloidosis Centre (NAC) stages. N-terminal pro–B-type natriuretic peptide (NT-proBNP) and troponin T levels were significantly associated with FGF23 tertiles. NT-proBNP medians across tertiles were 1,608, 2,920, and 1,948.5 pg/mL, respectively (P = 0.0084). Higher FGF23 levels were significantly associated with advanced NAC classification, and cumulative probability modeling supported its association with disease stage. After adjustment for eGFR, FGF23 remained significantly associated with NT-proBNP (Spearman’s ρ = 0.16; p = 0.084). However, the association with troponin T did not reach statistical significance (ρ = 0.19; p = 0.043), representing a non-significant trend. This is the first study to demonstrate a significant association between FGF23 and established markers of cardiac injury and disease staging in ATTR-CM, supporting FGF23 as a potential complementary biomarker for risk stratification.