Author + information
- Asuman Biçer Yeşilay1,
- Funda Yalçın2,
- Arzu Er3,
- Aysun Camuzcuoğlu4,
- Zekeriya Kaya1,
- Nurhan Korkmaz2,
- Yusuf Sezen1,
- Özgür Günebakmaz1,
- Mehmet Gencer2 and
- Recep Demirbağ1
Conflicting effects of vitamin B12 deficiency have been shown on the cardiovascular system. We evaluated left ventricular (LV) myocardial functions with a new imaging method, four-dimensional (4D) real-time full-volume strain echocardiography (SE), and myocardial performance index (MPI or Tei index) obtained from tissue Doppler echocardiography (TDE) in patients with vitamin B12 deficiency and a normal conventional echocardiographic study.
Thirty patients with vitamin B12 deficiency (B12 levels <200 pg/ml; mean age: 29.57±8.56, 18 female), and 32 healthy controls (B12 levels >200 pg/ml; mean age: 29.38±6.40, 15 female) were included in the study. Two- and 4D echocardiography images were transferred to a workstation for further offline analysis. Conventional echocardiography, TDE and 4D SE were performed on all subjects. MPI, left ventricle global longitudinal, circumferential and radial strain values were obtained.
Demographic and laboratory data, standard echocardiographic parameters, TDE velocities and MPI were comparable between the groups except for hemoglobin levels and ejection time. All 4D strain values in the patient group were significantly lower than those in the control group. There was a positive correlation between B12 levels and 4D strain values except longitudinal strain values, though we could not reveal an independent association of vitamin B12 levels with the strain values. We only found the body mass index as an independent predictor of the impaired longitudinal strain (Table 1).
Longitudinal, circumferential and radial myocardial deformation was impaired in patients with B12 deficiency, and only radial and circumferential impairment was correlated with the levels of vitamin B12.
|Pearson correlation Coefficient||p value||β-Regression Coefficient||p value|
BMI, body mass index; LVEDV, left ventricle end-diastolic volume; LVESV, left ventricle end-systolic volume; ET, ejection time; LVEF, left ventricle ejection fraction; FS, fractional shortening; SV, stroke volume; IVCT, isovolumetric contraction time.