Heart Failure patients 4 X less likely to benefit from pacemaker (CRT) if low vitamin D
Vitamin D deficiency and functional response to CRT in heart failure patients.
Herz. 2017 Oct 9. doi: 10.1007/s00059-017-4630-x
Separham A1, Pourafkari L1,2, Kazemi B1, Haghizadeh Y1, Akbarzadeh F1, Toufan M1, Sate H1, Nader ND3.
1 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Dept. of Anesthesiology, U. at Buffalo, 77 Goodell Suite #550, 14203, Buffalo, NY, USA.
3 Dept. of Anesthesiology, U. at Buffalo, 77 Goodell Suite #550, 14203, Buffalo, NY, USA. nnader@buffalo.edu.
BACKGROUND:
Vitamin D deficiency has been associated with a poor outcome in patients with heart failure (HF). We examined the role of vitamin D in the response of HF patients to cardiac resynchronization therapy (CRT).
METHODS:
The study comprised 50 patients (30 men and 20 women) with HF undergoing CRT implantation who were prospectively enrolled. Response to CRT was defined as a combination of ≥15% reduction in left ventricular end-systolic volume (LVESV) and ≥10% improvement in the 6-Minute Walk Test within 6 months. Patients were grouped based on their levels of vitamin D prior to CRT implantation. Clinical and echocardiographic examinations were performed prior to and 6 months after the procedure.
RESULTS:
Of the patients, 11 (22%) failed to respond to CRT; two patients died within 6 months and an additional nine patients showed no improvement in the 6-Minute Walk Test and no reduction in their baseline LVESV. A comparison was made between 25 patients with sufficient levels of vitamin D and 25 patients with insufficient levels.
Nine patients (36%) in the "insufficient" group and two patients (8%) in the "sufficient" group failed to respond to CRT implantation (p = 0.037).
CONCLUSION:
Adequate serum concentrations of vitamin D play a significant role in improving the functional status of patients with systolic HF following CRT implantation.