Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

Abstract

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.

Associations between Intrinsic Heart Rate, P Wave and QT Interval Durations and Pulse Wave Analysis in Patients with Hypertension and High Normal Blood Pressure

“…Arterial stiffness, the consequence of arteriosclerosis and subclinical atherosclerosis, is involved in cardiovascular disease development and, if assessed, can improve risk prediction, especially in hypertensive and intermediate risk patients [ 4 , 5 , 6 , 7 , 8 ].…”

Serum Osteoprotegerin and Carotid Intima-Media Thickness Are Related to High Arterial Stiffness in Heart Failure with Reduced Ejection Fraction

“…In the study of Buleu et al, which was performed on patients with HF and coronary artery disease vs. controls, OPG values were positively correlated with cfPWV. The mean PWV scores in both groups were below 10 m/s [ 39 ]. In 120 hemodialysis patients studied by Hou et al, higher tertiles of OPG were associated with greater cfPWV values and lower intact parathyroid hormone levels and were predictors of AS together with age, the presence of diabetes, and high serum calcium [ 40 ].…”

<p>Effects of Alpha-Lipoic Acid Supplementation on Cardiovascular Disease Risk Factors in β-Thalassemia Major Patients: A Clinical Trial Crossover Study</p>

“…However, comparing postintervention OPG level in thalassemic patients with OPG level in healthy subjects in the studies, it was found that the OPG level in thalassemic patients after intervention in this study is similar to the OPG level in healthy subjects and it seems that this level of serum OPG would reduce CVD risk and thus can be considered beneficial to thalassemic patients' health. 21,22 Lp-PLA 2 is a macrophage-derived enzyme that after oxidation of LDL can decompose oxidized phosphatidylcholine into lysophosphatidylcholine (LysoPC) and oxidized nonesterified free fatty acids (oxNEFA). 23 These compounds significantly contribute to inflammation associated with atherosclerosis and can stimulate monocytes and macrophages to secrete cytokines, which in turn cause more liberation of Lp-PLA 2 from macrophages.…”