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Total 25-Hydroxyvitamin D Is an Independent Marker of Left Ventricular Ejection Fraction in Heart Failure with

Timea Magdolna Szabo1,2, Előd Ernő Nagy3,4, Ádám Kirchmaier2

  • 1Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.

Biomolecules
|November 25, 2023
PubMed

Insights

Vitamin D deficiency is linked to worse heart failure outcomes. Lower 25-hydroxyvitamin D (25(OH)D) levels correlate with reduced left ventricular ejection fraction (LVEF) in heart failure patients, suggesting a need for targeted supplementation.

Area of Science:

  • Cardiology
  • Endocrinology
  • Biochemistry

Background:

  • Vitamin D is a recognized prognostic biomarker in heart failure (HF), but its therapeutic role remains debated.
  • Previous studies show mixed results regarding vitamin D supplementation benefits in HF patients, with improvements in cardiac remodeling and quality of life not consistently translating to better physical performance or survival.
  • Vitamin D deficiency may serve as a marker for left ventricular (LV) systolic dysfunction in heart failure with reduced and mildly reduced ejection fraction (HFrEF, HFmrEF).

Purpose of the Study:

  • To investigate the association between vitamin D levels, serum albumin, and uric acid with LV systolic dysfunction in patients with HFrEF and HFmrEF.
  • To explore vitamin D deficiency as a potential marker for LV systolic dysfunction in heart failure.
  • To analyze the relationship between 25-hydroxyvitamin D (25(OH)D) and left ventricular ejection fraction (LVEF) in HF patients.

Main Methods:

  • Seventy patients with LVEF < 50% underwent comprehensive evaluation including ECG, echocardiography, lung ultrasound (LUS), blood sampling, and the six-minute walk test (6MWT).
  • Health-related quality of life (HRQoL) was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
  • Statistical analyses, including univariate and multiple regression, were performed to determine correlations and independent associations, adjusting for potential confounders.

Main Results:

  • Significant positive correlations were observed between LVEF and 25(OH)D, serum uric acid (UA), and albumin.
  • Patients with severely reduced LVEF exhibited higher serum UA, NT-proBNP levels, and MLHFQ scores, but lower 25(OH)D concentrations.
  • 25(OH)D was independently associated with LVEF, even after adjusting for factors like age, NT-proBNP, chronic coronary syndrome, hypertension, and anemia.

Conclusions:

  • 25-hydroxyvitamin D (25(OH)D) is closely associated with left ventricular ejection fraction (LVEF) in heart failure patients.
  • The findings support the necessity of establishing appropriate vitamin D supplementation strategies and dietary interventions for individuals with heart failure.
  • Observed changes in LVEF, 25(OH)D, serum UA, and albumin levels in HFrEF and HFmrEF suggest a shared pathophysiological background.

Keywords:
heart failureheart failure with mildly reduced ejection fractionheart failure with reduced ejection fractionserum albuminserum uric acidvitamin D deficiency

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