Renal resistive index, indicator of arterial rigidity in patients with chronic heart failure and vitamin D deficit

Introduction: Vitamin D has become a key element in cardiovascular disease, both due to its cardioprotective properties and due to increased incidence of coronary artery disease and atherosclerosis in patients with vita-min D deficiency. In addition, individuals with IC re-gardless of values of the ejection fraction have arterial stiffness increased, this proving to be a strong predictor of mortality. Renal impairment, common in HF pati-ents, aggravates prognosis. The increased renal resistive index (RRI) may reflect vascular resistance as a good marker of vascular damage and implicitly of arterial stiffness.

Scope: T he study aimed to correlate correlation vita-min D levels and arterial stiffness indicators (c-f PWV, IMT, ABI) in patients with chronic heart failure (HF) consecutive to coronary artery disease (CAD) in stable condition.

Methods: Serum concentrations of 25-hydroxyvitamin D3 [25 (OH) D] were determined in 45 consecutive pa-tients with with chronic HF consecutive to CAD in stable condition. The total lot was divided into two groups according the serum vitamin D values, regardless of the severity of the coronary artery disease. Group A was composed of 38 patients (84.44%) with no vitamin D deficiency and with levels >20 ng / ml and group B in 7 patients (15.55%) with vitamin D deficiency and levels ≤20 ng / ml.

Results: The mean age (± SD) of patients was 63.97 ± 6.13 years for group A and 61.57 ± 5.25 for group B wi-thout statistically significant differences between groups (p =0.693). The mean vitamin D level was 23.45 ± 8.41 ng/ml, with limits between 10.21 and 37.15 ng / ml for the total lot. The mean ejection fraction was 41.71% ± 3.98 for patients in group B and significantly greater, and 46.74% ± 6.91 for group A (p=0.029). There was a statistically significant correlation of c-f PWV between the two groups (p=0.021) (9.77 ± 1.11 for group A vs. 10.9 ± 0.98 for group B). There was a statistically sig-nificant correlation with RRI between the two groups (p<0.001) (0.70 ± 0.01 for group A vs. 0.73 ± 0.01 for group B) respectively. There was no significant corre-lation with IMT between the two groups (p=0.279) and ABI between the two groups (p=0.242). There was a significant correlation between vitamin D and renal function, with elevated creatinine levels (p=0.03) and decreased glomerular filtration rate (p=0.001).

Conclusions: T he RRI could be determined together with c-f PWV and vascular calcification biomarker (25-OH-D3) in the monitoring of arterial rigidity in patients with heart failure. Together with renal func-tion assessment, these techniques could play a key role in identifying patients at increased risk of worsening disease prognosis and shorter life expectancy.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)