Research away from demographics, logical cues, and you can therapeutic and you will antique echocardiographic proportions had been registered for everybody customers
Right-sided HF was defined as the presence of one of your regular attacks (ankle swelling) or particular cues (jugular venous distention or abdominojugular reflux) away from right HF
Fasting venous blood samples were drawn from the study participants and analyzed on the same day. Renal function was assessed using the estimated glomerular filtration rate (eGFR), calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Whole blood counts were determined using an automated blood cell counter. Anemia was defined as a hemoglobin level <12 g/dL in women and <13 g/dL in men. 14 Ferritin, vitamin B12, folic acid, and NT-proBNP levels were estimated by chemiluminescence using the Beckman Coulter Access Immunoassay Systems. Iron and iron binding capacity were measured with Roche Cobas C 702 System. Iron deficiency was defined as a serum ferritin level <100 ng/mL for absolute deficiency, and 100–299 ng/mL with a transferrin saturation <20% for functional iron deficiency. 4,5 The reference interval for vitamin B12 by the manufacturer was 180–914 pg/mL. Vitamin B12 deficiency was defined as <200 pg/mL, and folic acid deficiency was defined as <4.0 ng/mL. 15,16
Tall correlates away from supplement B12 was basically analyzed on univariate linear regression design having fun with all of the systematic, echocardiographic, and you may lab details while the covariates
An enthusiastic endpoint of your own data are all of the-end up in death. Clients were implemented-until because of the outpatient check outs or because of the cell phone contact whenever they were not able to come to own visits.
The research was approved by the organization feedback panel of Kocaeli College or university and you may was a student in accordance towards the principles of the Helsinki Declaration. Composed told consent try taken from for each patient ahead of data collection.
All analyses were performed using SPSS 20.0 statistical software package (IBM Corporation, Armonk, NY, USA). Continuous variables are presented as mean and standard deviation when normally distributed, and as median and 25th–75th percentiles when non-normally distributed. Categorical variables are given as percentages. Patient groups and controls were compared by Student’s t-test or Mann–Whitney U-test when appropriate. The chi-square test was used for the comparison of categorical variables. Variables with a significant univariable correlation (P<0.10) were entered in the multivariable linear regression model. Receiver operating characteristic curve (ROC) analysis was performed to assess the cut-off value of vitamin B12 for predicting all-cause mortality. The Kaplan–Meier method was used to determine cumulative probability of all-cause mortality according to serum vitamin B12 level, and the survival curves were compared by the log-rank test. Cox proportional hazard regression model, adjusted for age, gender, presence of right HF, coronary artery disease, angiotensin converting enzyme (ACE)-inhibitor/angiotensin receptor blocker, beta-blocker, mineralocorticoid receptor antagonist usage, atrial fibrillation, systolic blood pressure, sodium, eGFR, NT-proBNP, hs-CRP, direct bilirubin, serum B12, ejection fraction, left ventricular end-diastolic diameter, left atrial diameter, right ventricular diameter, and pulmonary artery systolic pressure, was used to determine the independent prognostic determinants of mortality. A two-sided P-value <0.05 was accepted as statistically significant.
All writers got complete accessibility most of the analysis on research, and you can grabbed duty to your ethics of data and you may reliability regarding study studies.
The study group consisted of 129 chronic stable HF patients and 50 healthy subjects. Baseline characteristics of the HF patients and controls are shown in Table 1. Mean NYHA functional class of the heart failure with reduced ejection fraction (HFrEF) patients was 2.7±0.4, and 71 of them (55%) had symptoms or signs of right HF. Anemia was present in 64 (49.6%) of the patients and in six (12%) of the controls (P<0.001). Most of the HFrEF patients had iron deficiency (108; 83.7%). Serum vitamin B12 deficiency was significantly less frequent in HFrEF patients compared to controls (35 patients [27%] vs 24 controls [48%] respectively; P=0.006), and folic acid deficiency was similar between the two groups (10 patients [8%] vs 1 control [2%]; P=0.184). A total of 43 patients (33%) had received an implantable cardioverter defibrillator and/or cardiac resynchronization therapy. Median B12 levels were not different between those who had and had not received a device therapy (245 pg/mL vs 272 pg/mL, respectively; P=0.680). On the contrary, B12 levels in HFrEF patients with and without right HF were significantly higher compared to controls (HFrEF with right HF: median 311 pg/mL [220–449], HFrEF without right HF: median 235 pg/mL [178–392]; P=0.022), and all five cases with a B12 level higher than 800 pg/mL were in the HFrEF group (Figure 1).