Dr. Dr. Katharina Dörr, MBA
MedUni Wien RESEARCHER OF THE MONTH May 2022
Left ventricular hypertrophy (LVH) is highly prevalent in patients with end stage kidney disease, increasing their risk of cardiac events and mortality. Its development and progression are associated with Fibroblast growth factor 23 (FGF23), which rises with declining renal function. In this randomized-controlled trial we studied the effect of calcimimetic versus vitamin D therapy on LVH in 62 hemodialysis patients with secondary hyperparathyroidism for a duration of one year. We were able to show that FGF23 suppression by calcimimetic treatment inhibited the progression of LVH in comparison to vitamin D as visualized with the help of cardiac magnetic resonance imaging. A successful prevention of increasing hypertrophy may reduce the risk of sudden cardiac death in this population.
Selected Literature
- Dörr K, Kammer M, Reindl-Schwaighofer R, Lorenz M, Prikoszovich T, Marculescu R, Beitzke D, Wielandner A, Erben RG OR. Randomized Trial of Etelcalcetide for Cardiac Hypertrophy in Hemodialysis. Circ Res. 2021;11:1616-1625. doi:10.1161/CIRCRESAHA.120.318556
- McCullough PA, Chan CT, Weinhandl ED, Burkart JM BG. Intensive Hemodialysis, Left Ventricular Hypertrophy, and Cardiovascular Disease. Am J Kidney Dis. 2016;68:S5–S14. doi:10.1053/j.ajkd.2016.05.025
- Stevens SM, Reinier K CS. Increased Left Ventricular Mass as a Predictor of Sudden Cardiac Death: Is it Time to put it to the Test? Circ Arrhythmia Electrophysiol. 2013;6(1):212–217. doi:10.1161/CIRCEP.112.974931
- Faul C, Amaral AP, Oskouei B, Hu MC, Sloan A, Isakova T, Gutiérrez OM, Aquillon-Prada R, Lincoln J, Hare JM, Mundel M, Morales A, Scialla J, Fischer M, Solimen EZ, Chen J, Go AS, Rosas SE, Nessel L, Townsend RR, Feldman HI, St John Sutton M, Ojo A, Gadegb WM. FGF23 induces left ventricular hypertrophy. J Clin Investivation. 2011;121:4393–4408. doi:10.1172/JCI46122
- Moe SM, Chertow GM, Parfrey PS, Kubo Y, Block GA, Correa-Rotter R, Drüeke TB, Herzog CA, London GM, Mahaffey KW, Wheeler DC, Stolina M, Dehmel B, Goodman WG, Floege J ETI. Cinacalcet, Fibroblast Growth Factor-23, and Cardiovascular Disease in Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial. Circulation. 2015;132:27-39. doi:10.1161/CIRCULATIONAHA.114.013876
- Dörr K, Kammer M, Reindl-Schwaighofer R, Lorenz M, Loewe C, Marculescu R, Erben R OR. Effect of etelcalcetide on cardiac hypertrophy in hemodialysis patients: a randomized controlled trial (ETECAR-HD). Trials. 2019;20:601. doi:10.1186/s13063-019-3707-7