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The Relationship Between the Incidence of the Vitamin D Deficiency and the Heart Failure Stages in Patients with Chronic Heart Failure

Year 2020, Volume: 6 Issue: 2, 132 - 137, 31.07.2020

Abstract

Objective: Vitamin D deficiency is known to be associated with increased incidence of hypertension, myocardial infarction (MI), heart failure and stroke. This study aimed to investigate the relationship between vitamin D deficiency and heart failure stages in patients with chronic heart failure.
Materials and Methods: This study included 106 patients who were either treated in clinics or admitted to outpatient cardiology clinics between January and July 2010 in Turkey High Specialized Hospital. The patients were classified between NYHA classes I-IV and physical examination, echocardiography, electrocardiography and routine blood tests were performed on all patients. Blood tests were performed to determine vitamin D and parathormone levels from all patients.
Results and conclusion: The mean age of the patients included in the study was 65.67 ± 10.4 years. At least one risk factor was present in 95% of the patients, and hypertension was found as the most prevalent factor (73.58%). According to the NYHA classification, 41.50% of the vitamin D levels were less than 25 nmol / L and vitamin D levels of patients with NYHA class III and IV heart failure were significantly different (p <0.05). Comparison of the vitamin D levels in the patients with heart failure class C and D were significantly different (p <0.05). Moreover, a statistically positive correlation was found between the heart failure stages and Vitamin D levels (p < 0.05; r = 0.267). A negative and statistically significant relationship was identified between vitamin D and parathormone levels (p < 0.05, r = -0.417). Correlation analysis showed that as the class of heart failure increased, the severity of vitamin D deficiency elevated, and this was accompanied with an increased level of parathormone.
Conclusion: In conclusion it was observed that the prevalence of vitamin D deficiency was high in patients with stage C and D heart failure. Reasons for this may include the widespread urban lifestyle and inadequate daylight, disordered vitamin D absorption from intestines due to heart failure, and a decrease in active vitamin D synthesis due to a decrease in renal perfusion. When considering the roles of vitamin D on ventricular contractility, and vitamin D replacement therapy should be considered in heart failure patients and this should be investigated by more comprehensive studies.

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References

  • Referans1 Borst MH, Vervloet MG, Wee PM, Navis G. Cross talk between the renin-angiotensin-aldosterone system and vitamin D-FGF-23-klotho in chronic kidney disease. JASN. 2011;22: 1603–1609. Referans2 Zitterman A, Ernst JB, Prokop S, Fuchs U, Gruszka A, Dreier J. et all. Vitamin D supplementation of 4000 IU daily and cardiac function in patients with advanced heart failure: The EVITA trial. International Journal of Cardiology, 2019 Apr;280:117-123. https://doi.org/10.1016/j.ijcard.2019.01.027 0167-5273 Referns3 Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, Witteman JC, Stricker BH. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J 2004; 25:1614-19. Referans4 Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, Murabito JM, Vasan RS. Long-term trends in the incidence of and survival with heart failure. N Engl J Med 2002;347:1397-1402. Referans5 Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C, Niebauer J, Hooper J, Volk HD, Coats AJ, Anker SD. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation. 2000;102:3060-67. Referans6 Anderson JL, May HT, Horne BD, Bair TL, Hall NL, Carlquist JF, Lappé DL, Muhlestein JB; Intermountain Heart Collaborative (IHC) Study Group. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol. 2010; 106: 963-68. Referans7 Whitham, D.M. Vitamin D in chronic heart failure. Curr Heart Fail Rep. 2011; 8:123–130. DOI 10.1007/s11897-011-0048-6 Referans8 Desai CK, Huang J, Lokhandwala A, Fernandez A, Riaz IB, Alpert JS. The role of vitamin supplementation in the prevention of cardiovascular disease events. Clin Cardiol. 2014; 37:576–581. Referans9 Ford JA, MacLennan GS, Avenell A, Bolland M, Grey A, Witham M. et al. Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr. 2014;100: 746–55. DOI:10.3945/ajcn.113.082602 Referans10 Ameri P, Ronco D, Casu M, Denegri A, Bovio M, Menoni S., High prevalence of vitamin D deficiency and its association with left ventricular dilation: an echocardiography study in elderly patients with chronic heart failure. Nutr Metab Cardiovasc Dis. 2010; 20:633–40. Referans11 Witte KK, Byrom R. Micronutrients for chronic heart failure: end of the road or path to enlightenment? J Am Coll Cardio HF. 2014; 2:318–20. Referans12 Brinkley MD, Omair MA, Sandip KZ, Wang TJ. Correction to: Vitamin D and heart failure. Current Heart Failure Reports. 2018; 15: 280. https://doi.org/10.1007/s11897-018-0394-8 Referans13 The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and blood vessels. Boston: Little Brown, 1964. Referans14 Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et all. Vitamin D Deficiency and risk of cardiovascular disease. Circulation. 2008; 117: 503-511. Referans15 Porto CM, Silva VDL, Luz JSB, Filho BM, Silveria M. Association between vitamin D deficiency and heart failure risk in the elderly. ESC Heart Failure. 2018; 5:63–74 Referans16 Zitterman A, Ernst JB. Calciotropic and phoshaturic hormones in heart failure. Nutrition, Metabolism & Cardiovascular Disease. 2016; 26:971-9. Referans17 Gruson D, Lepoutre T, Ahn SA, Ketelslegers JM, Rousseau MF. Increased circulating concentrations of bioactive PTH 1-84 in patients with heart failure. Journal of Endocrinological Investigation. 2012;35(11):987–991 Referans18 Liu LC, Voors AA, van Veldhuisen DJ, van der Veer E, Belonje AM, Szymanski MK, et al. Vitamin D status and outcomes in heart failure patients. European Journal of Heart Failure. 2011; 13:619–625. (https://doi.org/10.1093/ eurjhf/hfr032) Referans19 Gotsman I, Shauer A, Zwas DR, Hellman Y, Keren A, Lotan C, et al. Vitamin D deficiency is a predictor of reduced survival in patients with heart failure; Vitamin D supplementation improves outcome. European Journal of Heart Failure. 2012; 14:357–366.

The Relationship Between the Incidence of the Vitamin D Deficiency and the Heart Failure Stages in Patients with Chronic Heart Failure

Year 2020, Volume: 6 Issue: 2, 132 - 137, 31.07.2020

Abstract

Objective: Vitamin D deficiency is known to be associated with increased incidence of hypertension, myocardial infarction (MI), heart failure and stroke. This study aimed to investigate the relationship between vitamin D deficiency and heart failure stages in patients with chronic heart failure.
Materials and Methods: This study included 106 patients who were either treated in clinics or admitted to outpatient cardiology clinics between January and July 2010 in Turkey High Specialized Hospital. The patients were classified between NYHA classes I-IV and physical examination, echocardiography, electrocardiography and routine blood tests were performed on all patients. Blood tests were performed to determine vitamin D and parathormone levels from all patients.
Results and conclusion: The mean age of the patients included in the study was 65.67 ± 10.4 years. At least one risk factor was present in 95% of the patients, and hypertension was found as the most prevalent factor (73.58%). According to the NYHA classification, 41.50% of the vitamin D levels were less than 25 nmol / L and vitamin D levels of patients with NYHA class III and IV heart failure were significantly different (p <0.05). Comparison of the vitamin D levels in the patients with heart failure class C and D were significantly different (p <0.05). Moreover, a statistically positive correlation was found between the heart failure stages and Vitamin D levels (p < 0.05; r = 0.267). A negative and statistically significant relationship was identified between vitamin D and parathormone levels (p < 0.05, r = -0.417). Correlation analysis showed that as the class of heart failure increased, the severity of vitamin D deficiency elevated, and this was accompanied with an increased level of parathormone.
Conclusion: In conclusion it was observed that the prevalence of vitamin D deficiency was high in patients with stage C and D heart failure. Reasons for this may include the widespread urban lifestyle and inadequate daylight, disordered vitamin D absorption from intestines due to heart failure, and a decrease in active vitamin D synthesis due to a decrease in renal perfusion. When considering the roles of vitamin D on ventricular contractility, and vitamin D replacement therapy should be considered in heart failure patients and this should be investigated by more comprehensive studies.

Project Number

Proje Numarası yoktur.

References

  • Referans1 Borst MH, Vervloet MG, Wee PM, Navis G. Cross talk between the renin-angiotensin-aldosterone system and vitamin D-FGF-23-klotho in chronic kidney disease. JASN. 2011;22: 1603–1609. Referans2 Zitterman A, Ernst JB, Prokop S, Fuchs U, Gruszka A, Dreier J. et all. Vitamin D supplementation of 4000 IU daily and cardiac function in patients with advanced heart failure: The EVITA trial. International Journal of Cardiology, 2019 Apr;280:117-123. https://doi.org/10.1016/j.ijcard.2019.01.027 0167-5273 Referns3 Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, Witteman JC, Stricker BH. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J 2004; 25:1614-19. Referans4 Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, Murabito JM, Vasan RS. Long-term trends in the incidence of and survival with heart failure. N Engl J Med 2002;347:1397-1402. Referans5 Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C, Niebauer J, Hooper J, Volk HD, Coats AJ, Anker SD. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation. 2000;102:3060-67. Referans6 Anderson JL, May HT, Horne BD, Bair TL, Hall NL, Carlquist JF, Lappé DL, Muhlestein JB; Intermountain Heart Collaborative (IHC) Study Group. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol. 2010; 106: 963-68. Referans7 Whitham, D.M. Vitamin D in chronic heart failure. Curr Heart Fail Rep. 2011; 8:123–130. DOI 10.1007/s11897-011-0048-6 Referans8 Desai CK, Huang J, Lokhandwala A, Fernandez A, Riaz IB, Alpert JS. The role of vitamin supplementation in the prevention of cardiovascular disease events. Clin Cardiol. 2014; 37:576–581. Referans9 Ford JA, MacLennan GS, Avenell A, Bolland M, Grey A, Witham M. et al. Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr. 2014;100: 746–55. DOI:10.3945/ajcn.113.082602 Referans10 Ameri P, Ronco D, Casu M, Denegri A, Bovio M, Menoni S., High prevalence of vitamin D deficiency and its association with left ventricular dilation: an echocardiography study in elderly patients with chronic heart failure. Nutr Metab Cardiovasc Dis. 2010; 20:633–40. Referans11 Witte KK, Byrom R. Micronutrients for chronic heart failure: end of the road or path to enlightenment? J Am Coll Cardio HF. 2014; 2:318–20. Referans12 Brinkley MD, Omair MA, Sandip KZ, Wang TJ. Correction to: Vitamin D and heart failure. Current Heart Failure Reports. 2018; 15: 280. https://doi.org/10.1007/s11897-018-0394-8 Referans13 The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and blood vessels. Boston: Little Brown, 1964. Referans14 Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et all. Vitamin D Deficiency and risk of cardiovascular disease. Circulation. 2008; 117: 503-511. Referans15 Porto CM, Silva VDL, Luz JSB, Filho BM, Silveria M. Association between vitamin D deficiency and heart failure risk in the elderly. ESC Heart Failure. 2018; 5:63–74 Referans16 Zitterman A, Ernst JB. Calciotropic and phoshaturic hormones in heart failure. Nutrition, Metabolism & Cardiovascular Disease. 2016; 26:971-9. Referans17 Gruson D, Lepoutre T, Ahn SA, Ketelslegers JM, Rousseau MF. Increased circulating concentrations of bioactive PTH 1-84 in patients with heart failure. Journal of Endocrinological Investigation. 2012;35(11):987–991 Referans18 Liu LC, Voors AA, van Veldhuisen DJ, van der Veer E, Belonje AM, Szymanski MK, et al. Vitamin D status and outcomes in heart failure patients. European Journal of Heart Failure. 2011; 13:619–625. (https://doi.org/10.1093/ eurjhf/hfr032) Referans19 Gotsman I, Shauer A, Zwas DR, Hellman Y, Keren A, Lotan C, et al. Vitamin D deficiency is a predictor of reduced survival in patients with heart failure; Vitamin D supplementation improves outcome. European Journal of Heart Failure. 2012; 14:357–366.
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Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Gökhan Keskin 0000-0002-1695-5624

Project Number Proje Numarası yoktur.
Publication Date July 31, 2020
Submission Date June 1, 2020
Acceptance Date July 31, 2020
Published in Issue Year 2020 Volume: 6 Issue: 2

Cite

APA Keskin, G. (2020). The Relationship Between the Incidence of the Vitamin D Deficiency and the Heart Failure Stages in Patients with Chronic Heart Failure. International Journal of Computational and Experimental Science and Engineering, 6(2), 132-137.