Abstract
Background and aims
Vitamin D deficiency has been associated with chronic heart failure (CHF). We evaluated
vitamin D levels in relationship with New York Heart Association (NYHA) classes, N-terminal
pro-brain natriuretic peptide (NT-proBNP) values and left ventricular (LV) measures
in ≥60 year old patients with stable CHF. Differently from previous investigations,
LV function was assessed by transthoracic echocardiography, to provide easily reproducible
results.
Methods and results
The study was performed at geographic latitude 44° N, from March to May and from September
to November 2008. Acute HF and diseases or drugs altering vitamin D status were exclusion
criteria. NYHA scores and 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D and
NT-proBNP concentrations were assessed in 90 (45 F, 45 M) Caucasian patients with CHF secondary to hypertension and/or coronary artery disease.
Vitamin D levels were also measured in 31 subjects without heart disease (controls).
LV echocardiography was performed in 52 (26 F, 26 M) representative patients. Vitamin D concentrations were significantly lower in CHF
cases than in controls. Among subject with CHF, 97.8% presented vitamin D deficiency
(25(OH)D<75 nmol/L), being severe (<25 nmol/L) in 66.7%. LV end-diastolic and end-systolic diameters were significantly longer,
LV end-diastolic and end-systolic volumes bigger and fractional shortening lower in
CHF patients with 25(OH)D<25 nmol/L than with 25(OH)D≥25 nmol/L (p<0.05). Log-values of 25(OH)D were negatively correlated with LV end-systolic diameter
and volume (r=−0.28; p<0.05). On subgroup analysis, these results persisted only in male patients.
Conclusions
In elderly CHF patients, vitamin D deficiency was highly prevalent and often severe.
This first addressed echocardiography study showed a sex-specific association between
vitamin D deficiency and LV dilation. Since further echocardiography data are easily
obtainable, larger investigations are demanded.
Keywords
Abbreviations:
25(OH)D (25-hydroxyvitamin D), 1,25(OH)2D (1,25-dihydroxyvitamin D), CHF (chronic heart failure), NYHA (New York Heart Association), NT-proBNP (N-terminal pro-brain natriuretic peptide), LV (left ventricular), EDD (end-diastolic diameter), ESD (end-systolic diameter), EDV (end-diastolic volume), ESV (end-systolic volume), PTH (parathyroid hormone)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 16, 2010
Accepted:
January 1,
2010
Received in revised form:
October 31,
2009
Received:
July 17,
2009
Identification
Copyright
© 2010 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
