Turk Kardiyol Dern Ars. 2016; 44(8): 670-676 | DOI: 10.5543/tkda.2016.28848
Vitamin D levels predict the response to cardiac resynchronization therapy in patients with systolic heart failure
, Adem Özkan2
, Hikmet Yorgun3
, Uğur Canpolat3
, Naresh Maharjan3
, Serkan Asil3
, Ergün Barış Kaya3
, Tülin Bayrak2
, Lale Tokgözoğlu3
, Asuman Özkara2
, Kudret Aytemir3
, Ali Oto31
Department Of Cardiology, Dışkapı Yıldırım Beyazıt Training And Research Hospital, Ankara, Turkey2
Department Of biochemistry, Hacettepe University, Ankara, Turkey3
Department Of Cardiology, Hacettepe University, Ankara, Turkey
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: 1.0191.417, p=0.006; BNP OR: 0.997, 95% CI: 0.9940.999, p=0.029; vitamin D OR: 1.121, 95% CI: 1.0111.242, 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.
Cardiac resynchronization therapy, heart failure, vitamin D.
How to cite this article
Hamza Sunman, Adem Özkan, Hikmet Yorgun, Uğur Canpolat, Naresh Maharjan, Serkan Asil, Ergün Barış Kaya, Tülin Bayrak, Lale Tokgözoğlu, Asuman Özkara, Kudret Aytemir, Ali Oto. Vitamin D levels predict the response to cardiac resynchronization therapy in patients with systolic heart failure. Turk Kardiyol Dern Ars. 2016; 44(8): 670-676
Corresponding Author: Hamza Sunman, Türkiye