1 research outputs found
Short-term changes in klotho and FGF23 in heart failure with reduced ejection fractionâa substudy of the DAPA-VO2 study
The klotho and fibroblast growth factor 23 (FGF-23) pathway is implicated in cardiovascular pathophysiology. This substudy aimed to assess the changes in klotho and FGF-23 levels 1-month after dapagliflozin in patients with stable heart failure and reduced ejection fraction (HFrEF). The study included 29 patients (32.2% of the total), with 14 assigned to the placebo group and 15 to the dapagliflozin, as part of the double-blind, randomized clinical trial [DAPA-VO2 (NCT04197635)]. Blood samples were collected at baseline and after 30 days, and Klotho and FGF-23 levels were measured using ELISA Kits. Between-treatment changes (raw data) were analyzed by using the Mann-Whitney test and expressed as median (p25%âp75%). Linear regression models were utilized to analyze changes in the logarithm (log) of klotho and FGF-23. The median age was 68.3 years (60.8â72.1), with 79.3% male and 81.5% classified as NYHA II. The baseline medians of left ventricular ejection fraction, glomerular filtration rate, NT-proBNP, klotho, and FGF-23 were 35.8% (30.5â37.8), 67.4â
ml/min/1.73â
m2 (50.7â82.8), 1,285â
pg/ml (898â2,305), 623.4â
pg/ml (533.5â736.6), and 72.6â
RU/ml (62.6â96.1), respectively. The baseline mean peak oxygen uptake was 13.1â±â4.0â
ml/kg/min. Compared to placebo, patients on dapagliflozin showed a significant median increase of klotho [Î+29.5, (12.9â37.2); pâ=â0.009] and a non-significant decrease of FGF-23 [Îâ4.6, (â1.7 to â5.4); pâ=â0.051]. A significant increase in log-klotho (pâ=â0.011) and a decrease in log-FGF-23 (pâ=â0.040) were found in the inferential analysis. In conclusion, in patients with stable HFrEF, dapagliflozin led to a short-term increase in klotho and a decrease in FGF-23