Association of serum calcium and phosphorus with measures of left ventricular structure and function: The ARIC study

Kripa Poudel, Amil M. Shah, Erin D. Michos, Aaron R. Folsom, Suma Konety, Pamela L. Lutsey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background and aims: Elevated serum calcium and phosphorus have been associated with increased risk of cardiovascular disorders. We evaluated whether abnormal calcium and high serum phosphorus are associated cross-sectionally with echocardiographic measures of left ventricular (LV) structure and function, as doing so may provide insight into the etiology of cardiac disorders. Methods and results: Included in the analysis were 5213 Atherosclerosis Risk in Communities Study (ARIC) participants who in 2011–2013 had echocardiography and serum calcium and phosphorus measurements. We evaluated the association of serum calcium (corrected for albumin) and phosphorus quintiles with measures of LV structure and function, after adjusting for other cardiovascular risk factors. Participants were on average 75.3 years old; 59.1% were female and 19.8% were African American. Mean (±SD) concentrations of calcium and phosphorus were 9.33 ± 0.38 and 3.46 ± 0.45 mg/dL, respectively. Higher calcium was associated with lower LV end-diastolic diameter (LVEDD) but greater prevalence of concentric remodeling (p-trend: 0.005 and 0.004 respectively). We observed association between high phosphorus and high septal E/e’ (p-trend: 0.02). Likewise, higher serum phosphorus was associated with higher left atrial volume index (p-trend: 0.001) and LV hypertrophy prevalence (p-trend: 0.04). Conclusions: In conclusion, higher calcium was associated with more concentric remodeling but lower LVEDD, suggesting complex associations between calcium and cardiac function. Serum phosphorus was related to worse indices of LV diastolic function and LV hypertrophy, but not to LV systolic function. However, the magnitudes of association were modest, so clinical implications of these findings may be limited.

Original languageEnglish (US)
Pages (from-to)758-767
Number of pages10
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume30
Issue number5
DOIs
StatePublished - May 7 2020

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities Study is supported by U.S. National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI) contracts ( HHSN268201100005C , HHSN268201100006C , HHSN268201100007C , HHSN268201100008C , HHSN2682011-00009C , HHSN268201100010C , HHSN268201100011C , and HHSN268201100012C ). Dr. Shah is supported by NIH NHLBI grants R01HL135008 and R01HL143224 .

Funding Information:
The Atherosclerosis Risk in Communities Study is supported by U.S. National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI) contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN2682011-00009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C). Dr. Shah is supported by NIH NHLBI grants R01HL135008 and R01HL143224.Dr Shah receives research support from Novartis. He serves as a consultant from Bellerophon Therapeutics and Philips Ultrasound.

Keywords

  • Echocardiography
  • Left ventricular function
  • Left ventricular structure
  • Serum calcium
  • Serum phosphorus

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Research Support, N.I.H., Extramural

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