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Heart Failure patients 4 X less likely to benefit from pacemaker (CRT) if low vitamin D – Oct 2017

Vitamin D deficiency and functional response to CRT in heart failure patients.

Herz. 2017 Oct 9. doi: 10.1007/s00059-017-4630-x. [Epub ahead of print]
Separham A1, Pourafkari L1,2, Kazemi B1, Haghizadeh Y1, Akbarzadeh F1, Toufan M1, Sate H1, Nader ND3.
1 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Dept. of Anesthesiology, U. at Buffalo, 77 Goodell Suite #550, 14203, Buffalo, NY, USA.
3 Dept. of Anesthesiology, U. at Buffalo, 77 Goodell Suite #550, 14203, Buffalo, NY, USA. nnader at buffalo.edu.

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Vitamin D deficiency has been associated with a poor outcome in patients with heart failure (HF). We examined the role of vitamin D in the response of HF patients to cardiac resynchronization therapy (CRT).

The study comprised 50 patients (30 men and 20 women) with HF undergoing CRT implantation who were prospectively enrolled. Response to CRT was defined as a combination of ≥15% reduction in left ventricular end-systolic volume (LVESV) and ≥10% improvement in the 6-Minute Walk Test within 6 months. Patients were grouped based on their levels of vitamin D prior to CRT implantation. Clinical and echocardiographic examinations were performed prior to and 6 months after the procedure.

Of the patients, 11 (22%) failed to respond to CRT; two patients died within 6 months and an additional nine patients showed no improvement in the 6-Minute Walk Test and no reduction in their baseline LVESV. A comparison was made between 25 patients with sufficient levels of vitamin D and 25 patients with insufficient levels.
Nine patients (36%) in the "insufficient" group and two patients (8%) in the "sufficient" group failed to respond to CRT implantation (p = 0.037).

Adequate serum concentrations of vitamin D play a significant role in improving the functional status of patients with systolic HF following CRT implantation.

PMID: 28993847 DOI: 10.1007/s00059-017-4630-x Publisher wants $40 for PDF

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