Clinical staging in chronic heart failure associated with low vitamin D and elevated parathormone levels

• Published in: Acta Cardiologica 2014-12, Vol.69 (6), p.665-671
• Main Authors: Belen, Erdal, Tıpı, Fahri Fatih, Aykan, Ahmet Çağrı, Findikçioğlu, Uğur, Karakuş, Gültekin, Yeşıl, Atakan, Helvaci, Aysen, Kalaycioğlu, Ezgi, Çetın, Mustafa
• Format: Article
• Language: English
• Subjects: Aged; Case-Control Studies; Chronic Disease; Disease Progression; Echocardiography; Female; Heart failure; Heart Failure - blood; Heart Failure - classification; Heart Failure - diagnostic imaging; Humans; Male; parathormone; Parathyroid Hormone - blood; Risk Factors; vitamin D; Vitamin D - blood
• ISSN: 0001-5385; 0373-7934
• DOI: 10.1080/AC.69.6.1000009

Objective Growing evidence in the literature suggests a relationship between heart failure and vitamin D-parathormone cascade. The aim of the present study was to investigate the association of the clinical stage of the heart failure with vitamin D-parathormone levels. Methods and results Ninety consecutive patients, who were admitted to our clinic from December 2012 to May 2013, were included in the present study. The patients with heart failure were clinically classified into four stages (stage A through stage D). Vitamin D and parathormone levels were measured and echocardiographic recordings were obtained from each patient. The patients with heart failure had significantly lower vitamin D levels compared to the control group (14.5 ng/ml versus 38 ng/ml, P< 0.001). In the four subgroups of patients with heart failure, vitamin D levels significantly decreased (30 ng/ml, 25 ng/ml, 13.5 ng/ml, and 6 ng/ml in stages A, B, C, and D, respectively), and parathormone levels significantly increased (50 pq/ml, 44 pq/ml, 70 pq/ml, and 98.5 pg/ml, respectively) with progression in the heart failure from stage A to stage D (P0.001). The log10 EF (B = -2.39, 95% CI = -3.36--1.42, P< 0.001), log10 BNP (B = 0.405, 95% CI = 0.13-0.69, P= 0.005, log10 vitamin D (B = -0.75, 95% CI = -1.18--0.31, P= 0.001) were the independent predictors of heart failure stage in multivariate regression analysis. Conclusions Vitamin D and parathormone levels were closely associated with the stage of heart failure. There was a significant decrease in vitamin D levels and a significant increase in serum parathormone levels with clinical deterioration in heart failure.