Introduction and Aims: Heart failure (HF) is a health problem with poor prognosis, despite many treatments available. Vitamin D is the prehormone of the active calcitriol (1,25(OH)2D3). It is involved in bone homeostasis, but recent studies suggest extra skeletal functions, including pleiotropic effects on cardiovascular system and a relationship between low levels of 25OH-D and worse HF prognosis. The aims of the study were: 1) to define 25 OH-D levels in the HF population, 2) to correlate 25 OH-D levels and HF outcome markers (biochemical and instrumental evaluation) in the hypothesis vitamin D represents a potential “modifiable" factor risk in HF. Materials and Methods: We performed a retrospective study on 261 consecutive HF patients (NHYA 1–3), collecting clinical, biochemical and instrumental data (echocardiography and cardiopulmonary exercise test–CPET). We retrieved stored blood samples collected at the baseline and developed a fast isotope dilution mass spectrometry coupled with liquid chromatography (HPLC-MS-MS) method for accurate measurement of 25OH-D levels. Results: Patients were 47 females and 214 males (ratio M:F=4:1), with a mean age of 65±12 years and mean BMI of 28±14. They had stable HF disease in prevalent NYHA 2class. Mean EF (ejection fraction) was 33± 8 %; patients had mild kidney failure (creatinine 1.12 ± 0.3 mg/dl) and they were normocalcemic and normo-PTH. Levels of 25OHvitaminD ranged 2–45 ng/ml, with mean of 17 ± 9 ng/ml. 25 % (n=65)patients had vitamin D deficiency (<10 ng/ml), 62 % (n=161)had vitamin insufficiency (between 10–30 ng/ml) and 13 %(n= 35) had vitamin >30 ng/ml, without any supplementation. The linear regression analysis showed that 25OH-D levels were positively correlated with CPET parameters and negatively with mortality Mecki score and this relation was even stronger inpatient with vitamin D insufficiency. Conclusion: Our study revealed a strong association between variables from CPET, a well recognized valuable tool for HF prognosis and 25OH-D levels, detected with a new and accurate method HPLC- MS-MS.
HPLC-MS-MS 25OHVITAMIND LEVELS ARE ASSOCIATED WITH PROGNOSIS MARKERS OF HEART FAILURE
Saponaro F
Primo
Project Administration
;Marcocci C;Saba A;Zucchi R;
2016-01-01
Abstract
Introduction and Aims: Heart failure (HF) is a health problem with poor prognosis, despite many treatments available. Vitamin D is the prehormone of the active calcitriol (1,25(OH)2D3). It is involved in bone homeostasis, but recent studies suggest extra skeletal functions, including pleiotropic effects on cardiovascular system and a relationship between low levels of 25OH-D and worse HF prognosis. The aims of the study were: 1) to define 25 OH-D levels in the HF population, 2) to correlate 25 OH-D levels and HF outcome markers (biochemical and instrumental evaluation) in the hypothesis vitamin D represents a potential “modifiable" factor risk in HF. Materials and Methods: We performed a retrospective study on 261 consecutive HF patients (NHYA 1–3), collecting clinical, biochemical and instrumental data (echocardiography and cardiopulmonary exercise test–CPET). We retrieved stored blood samples collected at the baseline and developed a fast isotope dilution mass spectrometry coupled with liquid chromatography (HPLC-MS-MS) method for accurate measurement of 25OH-D levels. Results: Patients were 47 females and 214 males (ratio M:F=4:1), with a mean age of 65±12 years and mean BMI of 28±14. They had stable HF disease in prevalent NYHA 2class. Mean EF (ejection fraction) was 33± 8 %; patients had mild kidney failure (creatinine 1.12 ± 0.3 mg/dl) and they were normocalcemic and normo-PTH. Levels of 25OHvitaminD ranged 2–45 ng/ml, with mean of 17 ± 9 ng/ml. 25 % (n=65)patients had vitamin D deficiency (<10 ng/ml), 62 % (n=161)had vitamin insufficiency (between 10–30 ng/ml) and 13 %(n= 35) had vitamin >30 ng/ml, without any supplementation. The linear regression analysis showed that 25OH-D levels were positively correlated with CPET parameters and negatively with mortality Mecki score and this relation was even stronger inpatient with vitamin D insufficiency. Conclusion: Our study revealed a strong association between variables from CPET, a well recognized valuable tool for HF prognosis and 25OH-D levels, detected with a new and accurate method HPLC- MS-MS.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
