Vitamin D Deficiency Predicts Poor Clinical Outcomes in Heart Failure Patients Undergoing Cardiac Resynchronization...

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Cardiac resynchronization therapy (CRT) benefits heart failure (HF) patients with reduced ejection fraction and wide QRS.
• Some HF patients do not respond to CRT, necessitating biomarkers for patient selection.
• Low vitamin D levels are increasingly associated with HF pathogenesis and progression.

Purpose of the Study:

• To investigate the association between vitamin D levels and clinical outcomes in HF patients undergoing CRT.
• To determine if vitamin D status can predict mortality and response to CRT.

Main Methods:

• 136 HF patients undergoing CRT were enrolled.
• Plasma vitamin D levels were measured at baseline and 6 months.
• Primary endpoint: 5-year all-cause mortality. Secondary endpoint: lack of good clinical response (less than 15% LVEF increase at 6 months).

Main Results:

• Vitamin D levels below 24.13 ng/mL predicted 5-year mortality (p=0.045).
• Low vitamin D levels also predicted poor clinical response to CRT (p=0.03) after adjustment.
• 58 patients reached the primary endpoint and 45 reached the secondary endpoint during follow-up.

Conclusions:

• Vitamin D deficiency is an independent predictor of poor midterm clinical response in HF patients undergoing CRT.
• Vitamin D deficiency is also an independent predictor of long-term mortality in this patient group.
• Monitoring vitamin D status in HF patients undergoing CRT may hold clinical significance.