Relation between Heart Failure Patients with Cardio-Renal Syndrome and Serum Levels of Vitamin D

Background: Worldwide, the prevalence of vitamin D deficiency is as high as almost 50% among the elderly and the association between vitamin D and heart failure is widely debated. Aim of work: To study the relation between serum 25-hydroxy vitamin D levels and echocardiographic parameters of cardiac function in heart failure patients with cardio-renal syndrome. Patients and methods: The study included 90 patients of all age groups and both sexes. They were divided into 3 groups of patients: 1: Systolic dysfunction and renal insufficiency (30 patients), 2: Systolic dysfunction only (30 patients). 3: Renal insufficiency only (30 patients). The Patients were subjected to full comprehensive echocardiography and kidney function tests with estimation of creatinine clearance, and measurement of Vitamin D level that was statistically studied against echocardiographic parameters of cardiac systolic and diastolic function. Results: Vitamin D deficiency (< 20 ng/ml) was significantly higher in patients with cardio-renal syndrome. Patients with vitamin D deficiency had a significantly higher left ventricular thickness and higher left ventricular (LV) mass which seems to be linked eventually to worse outcomes. The Worsening Diastolic function is still a matter of conflict but, at least in our study, Vitamin D deficiency was not associated with worse left ventricular diastolic dysfunction or abnormal left atrial volume (LAV) index. Due to highly significant negative correlation between mean wall thickness and Vitamin D level, a Roc curve was done revealing a sensitivity of 80% and a specificity of 72% for the mean wall thickness (≥ 10 mm) to identify patient with vitamin D deficiency. Conclusion: Vitamin D deficiency is highly prevalent in heart failure patients (especially those with cardiorenal syndromes) and has been shown to be associated with increased cardiovascular diseases, including left ventricular hypertrophy (higher LV thickness and mass) and heart failure.