Increased Vitamin B12 in stable heart failure patients is associated with increased direct bilirubin due to right HF, indicating a cardiohepatic syndrome, according to a recent study published in the journal Therapeutics and Clinical Risk Management. B12 levels in HF patients with and without right-sided HF were significantly higher compared to healthy controls.
Previous research has already established the association between elevated vitamin B12 and liver damage, but its significance in chronic stable heart failure (HF) was less known. Onur Argan and his associates conducted a study to investigate the clinical correlates and prognostic significance of vitamin B12 levels in stable systolic HF.
The study included a total of 129 patients with HF and 50 control subjects. Data regarding demographics, clinical signs, therapeutic and conventional echocardiographic measurements were recorded for all patients. Right-sided HF was defined as the presence of at least one of the typical symptoms (ankle swelling) or specific signs (jugular venous distention or abdominojugular reflux) of right HF.
The study found that :
- B12 levels in HF patients with and without right-sided HF were significantly higher compared to healthy controls (n=50): Median 311 pg/mL and 235 pg/mL vs 198 pg/mL, respectively.
- Folic acid levels were similar between the study groups.
- Age, ejection fraction, left atrial size, estimated glomerular filtration rate, and direct and indirect bilirubin levels were significantly correlated to serum B12 level in univariate analysis.
- In multivariate analysis, independent correlates of B12 were direct bilirubin and age.
- Patients with HF were followed-up for a median period of 32 months. Median B12 levels were significantly higher in patients who subsequently died (n=35) compared to survivors, but folic acid was not different between the two groups.
- ROC analysis showed that B12 values ≥270 pg/mL had 80% sensitivity and 58% specificity for predicting all-cause mortality.
- In Cox regression analysis, only left atrial diameter, level of direct bilirubin, and the presence of abdominojugular reflux were independent predictors of death.
Chronic heart failure happens when the heart muscle gets damaged after which it becomes weak and doesn’t pump properly. Once the heart is damaged, it can’t heal. The damage can be caused by a heart attack, or long-term health problems like high blood pressure, diabetes or heart disease.
For more information log on to https://doi.org/10.2147/TCRM.S164200
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