P287 RELATIONSHIP OF HYPOVITAMINOSIS D WITH HEART FAILURE DEVELOPMENT, HEART TRANSPLANTATION NECESSITY AND MORTALITY AMONG INDIVIDUALS WITH DILATED CARDIOMYOPATHY

Abstract

Abstract Background Non–ischemic dilated cardiomyopathy (DCM) is a progressive heart disease often affecting young individuals leading to heart failure (HF) development, heart transplantation (HT) and adverse outcome. We aimed to evaluate the prevalence of hypovitaminosis D among Italian patients with DCM and its prognostic value during follow–up. Methods Plasma vitamin D levels were measured in 204 patients with DCM enlisted from The Trieste Registry of Cardiomyopathies. The endpoints during follow–up were defined as the incidence of major ventricular arrhythmias (MVAs), HT, hospitalization for HF and all–cause mortality. Results The median concentration of vitamin D in our cohort was 20.7 (15.53–29.3) ng/ml) and the majority of enrolled individuals were vitamin D deficient (54.4%). Vitamin D levels positively correlated with left ventricular ejection fraction (LVEF) (R=0.216, p=0.002) and patients with LVEF > 35 have significantly higher plasma vitamin D concentration compared to patients with LVEF <= 35 (respectively, 22.7 (17.35 – 30.5) ng/ml vs 19.2 (13.0 – 26.35) ng/ml, p=0.009). During a median follow–up of 58.47 (38.05 – 74.97) months, 7.8% of patients died, 3.9% had HT, 12.3% of individuals were hospitalized for HF, and 12.7% suffered from MVAs. Deceased individuals, patients requiring HT and hospitalized for HF during follow–up were observed to have significantly lower plasma vitamin D values compared to living and event–free individuals at the end of follow–up (respectively, 18.65 (9.49 – 20.7) ng/ml vs 21.3 (15.75 – 29.58) ng/ml, p=0.046, 14.35 (7.03 – 17.85 ng/ml vs 20.9 (15.9 – 29.48) ng/ml, p=0.021, 15.5 (9.56 – 21.35) ng/ml vs 21.7 (16.2 – 29.5) ng/ml, p= 0.012). In addition, patients suffering from MVAs had lower vitamin D values compared to individuals without events, although not significant (18.8 (14.48 – 24.48) ng/ml 21.56 (15.6 – 29.53) ng/ml, p=0.219). Unfortunately, Kaplan–Meier analysis and multivariate Cox regression analysis did not show an association and prognostic feature of vitamin D levels with events as expected probably due to the limited number of samples. Conclusions Hypovitaminosis D is common in patients with DCM. Given that lower levels of vitamin D are noted among patients with MVA, HT, HF hospitalization and poor outcome, future studies with a larger cohort are needed to confirm its predictive value. Vitamin D supplementation should be highly recommended as part of preventive therapies in patients with DCM.