Changes and clinical significance of serum 25-OH-VitD3 level in patients with congestive heart failure

Liang Xianfeng; Zhang Qiang; Liang Xianxi

doi:10.3969/j.issn.1674-4055.2019.05.17

Abstract：Objective To explore the changes of serum 25-Dihydroxyvitamin D3 (25-OH-VitD3) level in patients with congestive heart failure (CHF) and its clinical significance. Methods A total of 141 patients with CHF admitted to department of cardiovascular medicine of Jingxi People’s hospital from September 2015 to September 2017 were collected, they were divided into NYHA class Ⅰ (n=32), NYHA class Ⅱ (n=43), NYHA class Ⅲ (n=37) and NYHA class VI (n=29) according to NYHA grading standard. At the same time, 40 healthy volunteers were randomly selected as control group. The serum 25-OH-VitD3 and N terminal pro-brain natriuretic peptide (NT-proBNP) was detected by enzyme-linked immunosorbent assay. Left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) was measured by echocardiography. Receiver operating characteristics curve (ROC) was used to evaluate the predictive value of 25-OH-VitD3 in poor prognosis of patients with CHF. Results The 25-OH-VitD3 and LVEF in CHF patients was lower than those in healthy volunteers, while NT-proBNP, LVESD, LVEDD in CHF patients was higher than those in healthy volunteers, the difference was statistically significant (P<0.05). With the increase of NYHA classification, the level of 25-OH-VitD3 and LVEF decreased gradually, and NT-proBNP, LVESD, LVEDD increased gradually, the difference was statistically significant (P<0.05). The Pearson product moment correlation analysis showed than serum 25-OH-VitD3 was negatively correlated with NT-proBNP (r=-0.728, P<0.05), negatively correlated with LVESD, LVEDD (r=-0.671, -0.629; P<0.05), and positively correlated with LVEF (r=0.724, P<0.05). During the follow-up period, 49 CHF patients (34.75%) had adverse cardiovascular events, the area under ROC curve of 25-OH-VitD3 for predicting adverse cardiovascular events in CHF patients was 0.846 (95%CI: 0.769~0.923), the cut-off value was 13.76 μg/L, the sensitivity and specificity were 0.82 and 0.76 respectively, and the accuracy was 0.79. The incidence of adverse cardiovascular events in 25-OH-VitD3<13.76 μg/L group was 49.25% (33/67), which was higher than 21.62% (16/74) in 25-OH-VitD3≥13.76 μg/L group, the difference was statistically significance (χ2=11.841, P<0.05). Conclusion 25-OH-VitD3 is obviously deficiency in CHF patients, which is closely related to the severity of heart failure. Early detection can be used as a predictor of poor prognosis in CHF patients.