The determination of heart failure with preserved systolic function by using Galectin-3 and other cardiac markers is affected by vitamin D status

Abstract

Objective: Vitamin D affects heart muscle contraction through its direct and indirect effects on calcium and phosphorus metabolism. We aimed to investigate N-terminal pro-brain natriuretic peptide, high-sensitive troponin-I, galectin-3, fibroblast growth factor-23, suppression of tumorigenesis-2, and parathormone levels concerning Vitamin-D status in patients with heart failure with preserved systolic function.

Materials and Methods: Seventy-one patients diagnosed with heart failure with preserved ejection fraction and 61 healthy individuals as a control group were enrolled in the study. The relation between vitamin-D level and heart failure with preserved ejection and the determination of cut-off levels of all parameters was evaluated using ROC and logistic regression analyses.

Results: While vitamin-D levels in the patient group were lower than the controls (median 14.5 vs. 21.11 ng/ml, P=0.002), N-terminal pro-brain natriuretic peptide, galectin-3, suppression of tumorigenesis-2 and parathormone levels in the patient group were significantly higher. The area under the curve values of these four elevated markers in the ROC analysis was significant for the diagnosis of heart failure with preserved ejection fraction. In the logistic regression analysis, a one-unit decrease in vitamin-D increased the risk of having heart failure with preserved systolic function 1,084 times, while a 10-unit categorical decrease in vitamin-D increased the risk 2,27 times. In the patient group, the area under the curves for N-terminal pro-brain natriuretic peptide, galectin-3, suppression of tumorigenesis-2 and parathormone were higher when vitamin-D was >20 ng/ml compared to the group with vitamin-D < 20 ng/ml.

Conclusions: N-terminal pro-brain natriuretic peptide, galectin-3, suppression of tumorigenesis-2 and parathormone were affected by the vitamin-D status in determining heart failure with preserved systolic function, with increased detection capability when vitamin-D is >20 ng/ml.