Akhabue E, Wong M, Mehta R, et al. - In this study, higher fibroblast growth factor-23 (FGF23) was found to be linked with greater odds of LVH, but not with greater increases in left ventricular mass (LVM) over time, among middle-aged adults without known cardiovascular disease (CVD) or chronic kidney disease (CKD).

• Increased FGF23 levels have been linked with greater LVM and heart failure.

• A total of 3,113 adults without CVD at baseline taking part in the Year 25 (2010-2011) follow-up exam of the Coronary Artery Risk Development in Young Adults (CARDIA) study, as well as 2,758 (88.6%) participants who returned for the Year 30 examination, were analyzed.

• Participants had a mean age 50.0 (±3.6) years (56.8% were female, 45.7% were Black and 6.4% had CKD).

• At Year 25, LVH prevalence was 6.0%, and mean 5-Year change in indexed LVM (LVMI=LVM/height ^2.7 ) was estimated to be 5.3 (±7.7) grams/meter.

• Greater odds of LVH at Year 25 were noted in relation to FGF23 in the highest quartile vs lower quartiles, in multivariable models [odds ratio 95% CI: 1.81 (1.28, 2.58)] with similar results post-exclusion of those with CKD.

• No association was found between FGF23 and global longitudinal strain, between FGF23 and 5-Year change in LVMI, and between higher FGF23 and 5-year incident LVH.