106 CHF patients are vitamin D deficient and hyperparathyroid, with levels of each related to markers of severity

Background The vitamin D-parathyroid (PTH) axis is increasingly recognised as potentially being involved with many of the features of the syndrome of CHF. We wanted to explore the relationship between vitamin D and PTH levels in a group of CHF patients and relate these to markers of severity. Methods We analysed serum 25(OH) vitamin D3 levels in 406 consecutive attendees of the Leeds Advanced Heart Failure clinic (310 men) and correlated these to clinical markers of severity. Results Mean age (SE) was 69 (3) years, mean left ventricular ejection fraction (LVEF) 31 (2)%, mean serum creatinine 117 μmol/l (2.4), median vitamin D levels (IQR) 30 (20–43) nmol/l (normal for skeletal health>75 nmol/l) and median parathyroid levels 8.8 (6.2–13.5) pmol/l (normal 2 ) 16.6 (0.5) ml/kg/min), there was a positive relationship between pVo 2 and vitamin D (Abstract 106 figure 4). Patients with diabetes had lower vitamin D levels than non-diabetics (p Conclusions The vitamin D-PTH axis is abnormal in CHF, related to the severity of the condition. Our data suggest that reverse remodelling in response to optimal drug titration is greater in those with higher vitamin D levels. Whether vitamin D deficiency is causally related to CHF remains unknown and requires a long-term, randomised, placebo-controlled study in CHF patients with efficacy and mechanistic outcomes, using a dose of vitamin D capable of normalising both vitamin D and PTH levels.