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

Matteo Briguglio, Luigi Gianturco, Daniele Stella, Chiara Colombo, Marika Bonadies, Oscar Sala, Mauro Anselmi, Giuseppe Banfi, Maurizio Turiel, Matteo Briguglio

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)519-522
Number of pages4
JournalJournal of Geriatric Cardiology
Volume15
Issue number8
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Global longitudinal strain
  • Left ventricular ejection fraction
  • Orthopedic surgery
  • Transthoracic echocardiography
  • Vitamin D

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

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