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. 2018 Aug;15(8):519-522.
doi: 10.11909/j.issn.1671-5411.2018.08.005.

Correction of hypovitaminosis D improved global longitudinal strain earlier than left ventricular ejection fraction in cardiovascular older adults after orthopaedic surgery

Matteo Briguglio  1 , Luigi Gianturco  1 , Daniele Stella  1 , Chiara Colombo  1 , Marika Bonadies  1 , Oscar Sala  1 , Mauro Anselmi  1 , Giuseppe Banfi  2   3 , Maurizio Turiel  1
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Correction of hypovitaminosis D improved global longitudinal strain earlier than left ventricular ejection fraction in cardiovascular older adults after orthopaedic surgery

Matteo Briguglio et al. J Geriatr Cardiol. 2018 Aug.

Abstract

Background: Cardiovascular diseases and insufficient levels of vitamin D are risk factors for adverse surgical outcomes, and they are both commonly present among older adults undergoing orthopaedic surgery. Giving the cardiovascular effects of vitamin D, pre-operative diagnosis of hypovitaminosis D would be a valuable step for the implementation of supplementation protocols. We investigated if the normalization of serum 25 [OH] D could ameliorate cardiac performance of older adults suffering from cardiovascular diseases.

Methods: We enrolled 47 older adults scheduled for major orthopaedic surgery and suffering from hypovitaminosis D. Patients underwent 6-months calcifediol supplementation with a starting dose at first post-operative day of 50 µg/die in liquid preparation. Down-titration to 20 µg/die at 3-months assessment was planned. Cardiac performance was evaluated by measuring left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) during pre-operative assessments and at 1-month, 3-months, 6-months follow-ups.

Results: Six months of calcifediol supplementation were associated with a significant improvement of both LVEF (+ 3.94%; 95% CI: -4.0789 to -0.8232; P < 0.01) and GLS (+ 18.56%; Z = -5.895; P < 0.0001).

Conclusions: Calcifediol supplementation normalized serum 25 [OH] D concentration after 1-month treatment. GLS offered better insights into myocardial contractile amelioration than LVEF, thus being useful for detecting earlier subclinical changes that may anticipate hemodynamic modifications.

Keywords: Global longitudinal strain; Left ventricular ejection fraction; Orthopedic surgery; Transthoracic echocardiography; Vitamin D.

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Figures

Figure 1.
Figure 1.. Median and interquartile ranges of serum 25 [OH] D during 6-months supplementation of calcifediol in drops.
Figure 2.
Figure 2.. Median and interquartile ranges of left ventricular ejection fraction during 6-months supplementation of calcifediol in drops.
Figure 3.
Figure 3.. Median and interquartile ranges of global longitudinal strain during 6-months supplementation of calcifediol in drops.
See this image and copyright information in PMC

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