Belen Erdal, Aykan Ahmet C, Kalaycioglu Ezgi, Sungur Mustafa A, Sungur Aylin, Cetin Mustafa
Department of Cardiology, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Ahi Evren Heart and Vascular Surgery Training and Research Hospital, Trabzon, Turkey.
Adv Clin Exp Med. 2016 Jan-Feb;25(1):51-7. doi: 10.17219/acem/34690.
Atrial fibrillation (AF) frequently accompanies heart failure (HF), and causes exacerbation of symptoms and treatment failure in such patients. Vitamin D was recently suggested to be an important mediator of cardiovascular disease, including HF.
The aim of this study was to evaluate the relationship between vitamin D deficiency and AF in patients with chronic HF.
The study included 180 chronic HF patients that were divided into 2 groups based on having sinus rhythm [AF (-) group] or chronic AF [AF (+) group]. Vitamin D status was assessed via measurement of the serum 25-hydroxyvitamin D (25[OH]D) concentration.
Mean age of the patients was 66 ± 8.7 years and 53.9% were male. There weren't any significant differences in age, gender, body mass index, etiology or chronic HF stage between the 2 groups. The vitamin D level in the AF (+) group was significantly lower than in the AF (-) group (11.05 ng/mL vs. 20 ng/mL, p < 0.001) and the parathyroid hormone level was significantly higher in the AF (+) group (76.7 vs. 55 pq mL, p < 0.001). The left atrium to body surface area ratio (LA/BSA) was significantly higher in the AF (+) group (45.03 mm/m2 vs. 42.05 mm/m2, p < 0.01). Independent predictors (based on multiple regression) of AF were vitamin D level (OR = 0.854, 95% CI: 0.805-0.907, p < 0.001) and LA/BSA ratio (OR = 1.077, 95% CI: 1.003-1.156, p < 0.05). The optimal vitamin D cut-off value for the prediction of AF was 16.50 ng/mL, with a sensitivity of 76.0% and specificity of 65.5% (AUC = 0.75, 95% CI: 0.67-0.82).
A low plasma vitamin D concentration was strongly associated with AF in patients with chronic HF.
心房颤动（AF）常伴有心力衰竭（HF），并导致此类患者症状加重和治疗失败。最近有研究表明维生素D是包括HF在内的心血管疾病的重要调节因子。
本研究旨在评估慢性HF患者维生素D缺乏与AF之间的关系。
本研究纳入180例慢性HF患者，根据是否存在窦性心律分为两组[AF（-）组]或慢性AF组[AF（+）组]。通过测量血清25-羟基维生素D（25[OH]D）浓度评估维生素D状态。
患者的平均年龄为66±8.7岁，男性占53.9%。两组在年龄、性别、体重指数、病因或慢性HF分期方面无显著差异。AF（+）组的维生素D水平显著低于AF（-）组（11.05 ng/mL对20 ng/mL，p<0.001），AF（+）组的甲状旁腺激素水平显著高于AF（-）组（76.7对55 pq mL，p<0.001）。AF（+）组的左心房与体表面积比（LA/BSA）显著更高（45.03 mm/m2对42.05 mm/m2，p<0.01）。AF的独立预测因素（基于多元回归）为维生素D水平（OR = 0.854，95%CI：0.805 - 0.907，p<0.001）和LA/BSA比值（OR = 1.077，95%CI：1.003 - 1.156，p<0.05）。预测AF的最佳维生素D临界值为16.50 ng/mL，敏感性为76.0%，特异性为65.5%（AUC = 0.75，95%CI：0.67 - 0.82）。
慢性HF患者血浆维生素D浓度低与AF密切相关。
