Key result
Ischemic HF linked to ~260% higher osteoprotegerin and lower vitamin D3 versus healthy controls.
Why the study?
The study aimed to correlate vascular calcification biomarkers and arterial stiffness indicators with left ventricular function parameters in heart failure patients versus controls.
Case-Control (n=120)
No
Absolute Event Rate: 4.7% vs 1.3%
p-value: p=<0.001
In patients with ischemic HFrEF, vitamin D deficiency significantly correlates with increased vascular stiffness and osteoprotegerin levels, suggesting a link between vascular calcification and disease severity.
Vitamin D deficiency and higher osteoprotegerin associate with ischemic HF; hypothesis-generating for vascular calcification links, requiring prospective validation.
Background and objectives: The purpose of the study is to correlate vascular calcification biomarkers osteoprotegerin (OPG) and 25-hydroxyvitamin D3 (25-OH-D3), indicators of arterial stiffness carotid-femoral pulse wave velocity (c-f PWV) and renal resistive index (RRI), with parameters of left ventricular function in heart failure patients versus control. Materials and methods: Our case-control study compared 60 patients with ischemic heart failure and reduced left ventricular ejection fraction (LVEF) (<40%) with a control group of 60 healthy age-matched subjects (CON). Serum levels of OPG and 25-OH-D3 were determined by ELISA. Left ventricular volumes (LVESV, LVEDV) and LVEF were measured by echocardiography. C-f PWV was determined using the arteriograph device. RRI was measured by duplex Doppler. Peak systolic velocity (PSV) and minimum end-diastolic velocity (EDV) were determined using angle correction. The estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation. The Pearson’s correlation coefficient was used for interpretation of results. Results: OPG values were significantly higher in heart failure (HF) patients vs. CON (4.7 ± 0.25 vs. 1.3 ± 0.67 ng/mL, p < 0.001). 25-OH vitamin D3 levels were significantly lower in HF patients vs. CON (20.49 ± 7.31 vs. 37.09 ± 4.59 ng/mL, p < 0.001). Multiple regression analysis considering 25-OH D3 as a dependent variable demonstrated indicators of vascular stiffness RRI, c-f PWV and vascular calcification biomarker OPG as predictors. OPG values were significantly correlated with cardiac parameters LVEDV (r = 0.862, p < 0.001), LVEF (r = −0.832, p < 0.001), and c-f PWV(r = 0.833, p < 0.001), and also with 25-OH-D3 (r = −0.636, p < 0.001). RRI values were significantly correlated with cardiac parameters LVEDV (r = 0.586, p < 0.001) and LVEF (r = −0.587, p < 0.001), and with eGFR (r = −0.488, p < 0.001), c-f PWV(r = 0.640, p < 0.001), and 25-OH-D3 (r = −0.732, p < 0.001). Conclusions: This study showed significant correlations between vitamin D deficit and vascular stiffness indicators in heart failure patients with reduced ejection fraction, demonstrating the importance of these examinations for a better evaluation of these patients. Together with the evaluation of renal function, the measurement of vascular stiffness indicators and biomarkers might play a key role in identifying patients at greater risk for worsening disease prognosis and for shorter life expectancy, who could benefit from vitamin D supplementation. The abstract was accepted for presentation at the Congress of the European Society of Cardiology, Munich, 2018.
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Buleu et al. (2019) conducted a case-control in Ischemic heart failure with reduced left ventricular ejection fraction (n=120). Ischemic heart failure vs. Healthy age-matched controls was evaluated on Serum osteoprotegerin (OPG) levels (ng/mL) (p=<0.001). Ischemic heart failure patients had significantly higher osteoprotegerin levels (4.7 vs 1.3 ng/mL) and lower 25-OH vitamin D3 levels (20.49 vs 37.09 ng/mL) compared to healthy controls.
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