Sunman Hamza, Özkan Adem, Yorgun Hikmet, Canpolat Uğur, Maharjan Naresh, Asil Serkan, Kaya Ergün Barış, Bayrak Tülin, Tokgözoğlu Lale, Özkara Asuman, Aytemir Kudret, Oto Ali
Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2016 Dec;44(8):670-676. doi: 10.5543/tkda.2016.28848.
The aim of this study was to examine the relationship between vitamin D levels in patients with heart failure (HF) and response to cardiac resynchronization therapy (CRT).
We studied 57 patients (mean age: 60.47±13.09 years) with New York Heart Association Class II or III heart failure, QRS duration ?120 milliseconds, and ejection fraction <35% (mean: 27.1±4.4%) who underwent CRT. All patients were taking optimal medical treatment for HF. Patients were classified as CRT responders if they had >15% decrease in left ventricular end-systolic volume at 6 months compared with baseline measurements. Vitamin D levels were evaluated before CRT implantation with ELISA.
Of the 57 patients, 34 patients (59.6%) were classified as responders and 23 patients (40.4%) were classified as non-responders. Baseline features, laboratory findings, and echocardiographic characteristics were nearly the same in both groups. High vitamin D level was detected in responder group compared to non-responder group (26.17±7.5 ng/mL vs 21.15±5.9 ng/mL; p=0.009). Age, hypertension, diabetes mellitus, ischemic cardiomyopathy, QRS morphology and duration, and levels of B-type natriuretic peptide (BNP) and vitamin D were associated with CRT response in our study population. In multivariate regression analysis, preimplantation QRS duration, and BNP and vitamin D levels remained independent predictors (QRS duration Odds ratio [OR]: 1.047, CI: 1.019-1.417, p=0.006; BNP OR: 0.997, 95% CI: 0.994-0.999, p=0.029; vitamin D OR: 1.121, 95% CI: 1.011-1.242, p=0.030).
In the present study, preimplantation level of vitamin D was found to be predictor of response to CRT.
本研究旨在探讨心力衰竭（HF）患者的维生素D水平与心脏再同步治疗（CRT）反应之间的关系。
我们研究了57例纽约心脏协会II级或III级心力衰竭、QRS时限≥120毫秒且射血分数<35%（平均：27.1±4.4%）并接受CRT治疗的患者（平均年龄：60.47±13.09岁）。所有患者均接受了针对HF的最佳药物治疗。如果患者在6个月时左心室收缩末期容积较基线测量值减少>15%，则被分类为CRT反应者。在CRT植入前用酶联免疫吸附测定法评估维生素D水平。
57例患者中，34例（59.6%）被分类为反应者，23例（40.4%）被分类为无反应者。两组的基线特征、实验室检查结果和超声心动图特征几乎相同。与无反应者组相比，反应者组检测到高维生素D水平（26.17±7.5纳克/毫升对21.15±5.9纳克/毫升；p=0.009）。在我们的研究人群中，年龄、高血压、糖尿病、缺血性心肌病、QRS形态和时限以及B型利钠肽（BNP）和维生素D水平与CRT反应相关。在多变量回归分析中，植入前QRS时限、BNP和维生素D水平仍然是独立预测因素（QRS时限优势比[OR]：1.047，可信区间[CI]：1.019 - 1.417，p=0.006；BNP OR：0.997，95%CI：0.994 - 0.999，p=0.029；维生素D OR：1.121，95%CI：1.011 - 1.242，p=0.030）。
在本研究中，发现植入前维生素D水平是CRT反应的预测因素。
Zotero 插件