, Volume 44, Issue 2, pp 147–154 | Cite as

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

  • A. Separham
  • L. Pourafkari
  • B. Kazemi
  • Y. Haghizadeh
  • F. Akbarzadeh
  • M. Toufan
  • H. Sate
  • N. D. NaderEmail author
Original articles



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.


Systolic heart failure Cardiac resynchronization therapy Myocardial remodeling Ventricular end-systolic volume 6-Minute Walk Test 

Vitamin-D-Mangel und funktionelle Antwort auf CRT bei Herzinsuffizienzpatienten



Vitamin-D-Mangel wird mit einem ungünstigen Verlauf bei Patienten mit Herzinsuffizienz in Zusammenhang gebracht. In der vorliegenden Arbeit wurde die Bedeutung von Vitamin D für die Antwort von Herzinsuffizienzpatienten auf eine kardiale Resynchronisationstherapie (CRT) untersucht.


Die vorliegende Studie umfasste 50 Patienten (30 m., 20 w.) mit Herzinsuffizienz und CRT-Implantation, die prospektiv in die Studie aufgenommen wurden. Als Therapieansprechen auf die CRT wurde die Kombination einer Verminderung des linksventrikulären endsystolischen Volumens (LVESV) von ≥15 % und einer Verbesserung im 6‑min-Gehtest von ≥10 % innerhalb von 6 Monaten definiert. Die Patienten wurden anhand ihrer Vitamin-D-Werte vor CRT in Gruppen eingeteilt. Eine klinische Untersuchung und eine Echokardiographie wurden vor und 6 Monate nach dem Eingriff durchgeführt.


Kein Therapieansprechen auf die CRT bestand bei 11 Patienten (22 %); 2 Patienten starben innerhalb von 6 Monaten und weitere 9 zeigten weder eine Verbesserung im 6‑min-Gehtest noch eine Verminderung ihres Ausgangs-LVESV. Es wurden 25 Patienten mit ausreichenden Vitamin-D-Werten und 25 Patienten mit nicht ausreichenden Werten verglichen. Kein Therapieansprechen auf die CRT gab es bei 9 Patienten (36 %) in der „nicht ausreichenden“ Gruppe und bei 2 Patienten (8 %) in der „ausreichenden“ Gruppe (p = 0,037).


Ausreichende Serumkonzentrationen von Vitamin D spielen eine bedeutende Rolle bei der Verbesserung der Leistungsfähigkeit von Patienten mit systolischer Herzinsuffizienz nach CRT-Implantation.


Systolische Herzinsuffizienz Kardiale Resynchronizationstherapie Myokardiales Remodeling Ventrikuläres endsystolisches Volumen 6-min-Gehtest 


Compliance with ethical guidelines

Conflict of interest

A. Separham , L. Pourafkari, B. Kazemi, Y. Haghizadeh, F. Akbarzadeh, M. Toufan, H. Sate, and N.D. Nader declare that they have no competing interests.

The study was approved by the local ethics committees of the university and all patients provided written informed consent according to the Declaration of Helsinki to participate in this study.


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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
  2. 2.Dept. of AnesthesiologyUniversity at BuffaloBuffaloUSA

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