25-hydroxyvitamin-d-2 and Ventricular-Dysfunction--Left

Vitamin D deficiency has been associated with increased risk for cardiovascular (CV) disease, but the possible effects of Vitamin D on cardiac structure and function are not well characterized.. The correlation between 25-hydroxyvitamin D levels and metabolic and cardiac echocardiographic parameters was studied in ARTEMIS study population including 831diabetic and 659 non-diabetic patients with stable coronary artery disease (CAD). Low levels of Vitamin D were associated with high BMI (p < 0.001), high total and LDL cholesterol and triglyceride levels (p < 0.001 for all) in both diabetics and non-diabetics. Among non-diabetic patients, low Vitamin D was also associated independently with elevated systolic and diastolic blood pressure (p < 0.005). Low Vitamin D levels were independently associated with reduced left ventricular (LV) ejection fraction (p < 0.005) and increased left atrial diameter (p < 0.03) measured by cardiac ultrasound by 2-dimensional echo. In the non-diabetic group, low Vitamin D levels were associated with impaired LV filling (high E/E') (p < 0.03) and low E/A mitral flow pattern measured by Doppler echocardiography (p < 0.05). Among diabetics, low Vitamin D levels were also related to increased LV end-systolic diameter (p < 0.05) and right ventricular diameter (p < 0.005). The association between LV diastolic filling (E/E') and Vitamin D levels was significant (p < 0.01) after adjustment for the commonly recognized risk factors of diastolic dysfunction in linear regression analysis.. Low Vitamin D is associated with several major cardiovascular risk factors and cardiac structural changes including impaired systolic and diastolic function, which together may explain the association of low Vitamin D to worse cardiovascular outcome.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Aged, 80 and over; Calcifediol; Cardiovascular Diseases; Cohort Studies; Coronary Artery Disease; Echocardiography, Doppler; Female; Finland; Heart; Heart Atria; Heart Ventricles; Humans; Male; Middle Aged; Nutritional Status; Organ Size; Prevalence; Risk Factors; Stroke Volume; Ventricular Dysfunction, Left; Vitamin D Deficiency

The purpose of this study was to identify the prevalence and clinical consequences of vitamin D insufficiency in patients with takotsubo cardiomyopathy.. Takotsubo cardiomyopathy is a syndrome of acute, transient left ventricular dysfunction seen predominantly in postmenopausal women after acute emotional or physical stress. Postmenopausal women have a high prevalence of bone and musculoskeletal consequences related to hypovitaminosis D. Although rickets is known to cause a reversible dilated cardiomyopathy in children, the importance of vitamin D for adult cardiovascular health is less understood.. We prospectively identified patients diagnosed with takotsubo cardiomyopathy at Danbury Hospital from April 2009 through January 2011, collected demographic, clinical, laboratory, and angiographic data, and performed serum 25 hydroxyvitamin D levels during the index hospitalization. Vitamin D insufficiency was defined as serum 25-hydroxy-vitamin D less than 30 ng/mL. We compared parameters of myocardial damage and heart failure between patients with and without vitamin D insufficiency. A χ² test and a Student's t test were used for categorical and continuous variables, respectively. Statistical significance was set at P < .05 (2 tailed).. Twenty-seven women were diagnosed with takotsubo cardiomyopathy during the study period. The mean age was 67.4 years (SD 10.4). The serum 25-hydroxyvitamin D levels were performed on 25 patients, and 17 of these had hypovitaminosis D (68%). A comparison of laboratory and imaging parameters between the 2 groups revealed that patients with hypovitaminosis D had a slightly higher mean left ventricular end-diastolic pressure and lower mean left ventricular ejection fraction (P < .05), suggestive of slightly worse heart failure.. Women diagnosed with takotsubo cardiomyopathy have a high prevalence of vitamin D insufficiency. In our prospective study of 25 women with takotsubo cardiomyopathy, this was associated with worse hemodynamic parameters.

Topics: 25-Hydroxyvitamin D 2; Aged; Calcifediol; Cohort Studies; Connecticut; Electronic Health Records; Female; Heart; Heart Failure; Hospitals, Urban; Humans; Middle Aged; Postmenopause; Prevalence; Prospective Studies; Severity of Illness Index; Stroke Volume; Takotsubo Cardiomyopathy; Ventricular Dysfunction, Left; Vitamin D Deficiency