Vitamin D levels predict the response to cardiac resynchronization therapy in patients with systolic heart failure

• Main Authors: Hamza Sunman (Author), Adem Özkan (Author), Hikmet Yorgun (Author), Uğur Canpolat (Author), Naresh Maharjan (Author), Serkan Asil (Author), Ergün Barış Kaya (Author), Tülin Bayrak (Author), Lale Tokgözoğlu (Author), Asuman Özkara (Author), Kudret Aytemir (Author), Ali Oto (Author)
• Format: Book
• Published: KARE Publishing, 2016-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Objective: The aim of this study was to examine the relationship between vitamin D levels in patients with heart failure (HF) and response to cardiac resynchronization therapy (CRT). Methods: We studied 57 patients (mean age: 60.47+-13.09 years) with New York Heart Association Class II or III heart failure, QRS duration ≥120 milliseconds, and ejection fraction <35% (mean: 27.1+-4.4%) who underwent CRT. All patients were taking optimal medical treatment for HF. Patients were classified as CRT responders if they had >15% decrease in left ventricular end-systolic volume at 6 months compared with baseline measurements. Vitamin D levels were evaluated before CRT implantation with ELISA. Results: Of the 57 patients, 34 patients (59.6%) were classified as responders and 23 patients (40.4%) were classified as non-responders. Baseline features, laboratory findings, and echocardiographic characteristics were nearly the same in both groups. High vitamin D level was detected in responder group compared to non-responder group (26.17+-7.5 vs 21.15+-5.9; p=0.009). Age, hypertension, diabetes mellitus, ischemic cardiomyopathy, QRS morphology and duration, and levels of B-type natriuretic peptide (BNP) and vitamin D were associated with CRT response in our study population. In multivariate regression analysis, preimplantation QRS duration, and BNP and vitamin D levels remained independent predictors (QRS duration Odds ratio [OR]: 1.047, CI: 1.019-1.417, p=0.006; BNP OR: 0.997, 95% CI: 0.994-0.999, p=0.029; vitamin D OR: 1.121, 95% CI: 1.011-1.242, p=0.030). Conclusion: In the present study, preimplantation level of vitamin D was found to be predictor of response to CRT, independent of BNP.

Item Description

1016-5169
10.5543/tkda.2016.28848