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<jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Evaluation of cardiac mechanics through two-dimensional speckle tracking echocardiography can identify early alterations in cardiac function.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In a subset of the Cardiovascular Health Study, c-terminal and intact fibroblast growth factor 23 were not independently associated with cardiac mechanic indices.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Elevated levels of fibroblast growth factor 23 (FGF23) are associated with left ventricular hypertrophy and heart failure in individuals with and without kidney disease. Prior studies investigated the association of FGF23 and structural cardiac changes using conventional echocardiography, which is limited in its ability to detect early cardiac dysfunction. We investigated the relationship between FGF23 levels and cardiac dynamics using two-dimensional speckle tracking echocardiography (2D-STE), a novel imaging modality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a cross-sectional analysis of data from the Cardiovascular Health Study (CHS), an ongoing prospective, population-based cohort study. The study population included 506 participants from CHS with available c-terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) measurements from 1996 to 1997 and 2D-STE images from 1994 to 1995. Forty-two percent of the study population had CKD, defined as an eGFR &lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , and the mean eGFR was 63 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      . The primary exposures were cFGF23 and iFGF23. The primary outcomes were six 2D-STE parameters performed at the 1994\u20131995 study visit. Linear regression models were used to examine the independent associations of FGF23 with six cardiac 2D-STE indices adjusting for demographics, cardiovascular risk factors, markers of kidney disease severity, and inflammation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      cFGF23 levels were moderately correlated with iFGF23 levels in the CHS population. In fully adjusted models, cFGF23 was associated with left atrial dysfunction, but no other cardiac imaging parameter (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      estimate, \u22122.47; 95% confidence interval, \u22124.68 to \u22120.25; Table 2). iFGF23 was not associated with any of the six 2D-STE indices. Limitations include small sample size and noncurrent FGF23 measurements and 2D-STE imaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a limited sample of individuals enrolled in the CHS with cFGF23 and iFGF23 measurements, we did not find consistent associations between FGF23 levels and 2D-STE parameters. Further investigations in a larger population with concurrent 2D-STE are needed to better understand the associations of FGF23 with early changes in cardiac mechanics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000000643","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T12:06:17Z","timestamp":1732017977000},"page":"391-399","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Association of Fibroblast Growth Factor 23 and Cardiac Mechanics in the Cardiovascular Health Study"],"prefix":"10.34067","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4950-5846","authenticated-orcid":false,"given":"Keertana","family":"Jain","sequence":"first","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7723-7469","authenticated-orcid":false,"given":"Ronit","family":"Katz","sequence":"additional","affiliation":[{"name":"Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9763-2367","authenticated-orcid":false,"given":"Tamara","family":"Isakova","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-7803","authenticated-orcid":false,"given":"Jorge R.","family":"Kizer","sequence":"additional","affiliation":[{"name":"Cardiology Section, San Francisco Veterans Affairs Health Care System, Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9011-0163","authenticated-orcid":false,"given":"Shilpa","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Psaty","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5655-8201","authenticated-orcid":false,"given":"Sanjiv J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-9869","authenticated-orcid":false,"given":"Joachim","family":"Ix","sequence":"additional","affiliation":[{"name":"Nephrology Section, Veterans Affairs San Diego Healthcare System, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5848-4325","authenticated-orcid":false,"given":"Rupal","family":"Mehta","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"},{"name":"Division of Nephrology, Department of Medicine, Jesse Brown Veterans Affairs Health Administration, Chicago, 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