Vitamin D deficiency and functional response to CRT in heart failure patients
A Separham1, L Pourafkari1,2, B Kazemi1
1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Vitamin D sufficiency is crucial for heart failure patients undergoing cardiac resynchronization therapy (CRT). Patients with adequate vitamin D levels showed significantly better response to CRT, improving functional status.
Area of Science:
- Cardiology
- Endocrinology
- Nutritional Science
Background:
- Vitamin D deficiency is linked to adverse outcomes in heart failure (HF) patients.
- The influence of vitamin D on the efficacy of cardiac resynchronization therapy (CRT) in HF requires further investigation.
Purpose of the Study:
- To investigate the association between pre-implantation vitamin D levels and patient response to CRT.
- To determine if vitamin D status impacts functional improvement in HF patients after CRT.
Main Methods:
- Prospective enrollment of 50 heart failure patients undergoing CRT implantation.
- Response to CRT defined by left ventricular end-systolic volume reduction and 6-Minute Walk Test improvement within 6 months.
- Patients categorized into sufficient and insufficient vitamin D groups based on pre-CRT serum levels.
Main Results:
- Overall, 22% of patients did not respond to CRT.
- Patients with insufficient vitamin D levels had a significantly higher non-response rate (36%) compared to those with sufficient levels (8%) (p=0.037).
- Sufficient vitamin D levels were associated with improved CRT response.
Conclusions:
- Adequate serum vitamin D concentrations are essential for optimizing functional outcomes in systolic heart failure patients receiving CRT.
- Maintaining sufficient vitamin D levels may enhance the effectiveness of CRT in heart failure management.
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.
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