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

Kripa Poudel1, Amil M Shah2, Erin D Michos3

  • 1Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA.

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|March 5, 2020
PubMed

Insights

High serum calcium and phosphorus levels are linked to heart issues. This study found calcium affects left ventricular (LV) size and remodeling, while phosphorus is associated with diastolic dysfunction and LV hypertrophy.

Area of Science:

  • Cardiology
  • Clinical Biochemistry
  • Cardiovascular Research

Background:

  • Elevated serum calcium and phosphorus are implicated in cardiovascular disease risk.
  • Understanding the relationship between these minerals and cardiac structure/function is crucial for disease etiology.
  • Echocardiography provides key metrics for assessing left ventricular (LV) health.

Purpose of the Study:

  • To investigate the cross-sectional association between abnormal serum calcium and high serum phosphorus levels with echocardiographic measures of LV structure and function.
  • To explore potential insights into the etiology of cardiac disorders linked to mineral imbalances.

Main Methods:

  • Analysis of 5213 participants from the Atherosclerosis Risk in Communities Study (ARIC) with available echocardiography and serum mineral data (2011-2013).
  • Evaluation of serum calcium (albumin-corrected) and phosphorus quintiles in relation to LV structure and function parameters.
  • Statistical adjustment for other cardiovascular risk factors.

Main Results:

  • Higher serum calcium correlated with lower LV end-diastolic diameter (LVEDD) and increased prevalence of concentric remodeling.
  • Elevated serum phosphorus was associated with higher septal E/e', increased left atrial volume index, and higher LV hypertrophy prevalence.
  • No significant association was found between serum phosphorus and LV systolic function.

Conclusions:

  • Higher serum calcium shows complex associations with cardiac structure, promoting remodeling but reducing LV chamber size.
  • Serum phosphorus is linked to impaired LV diastolic function and hypertrophy, though associations were modest.
  • Clinical implications of these findings may be limited due to modest effect sizes.
Abstract

Keywords:
EchocardiographyLeft ventricular functionLeft ventricular structureSerum calciumSerum phosphorus

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