Vitamin D & Vitamin D Deficiency

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Vitamin d and diastolic function

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Objective To determine the association between serum vitamin D level and left ventricular LV diastolic dysfunction. Background Vitamin D deficiency has been shown in observational and prospective studies to be associated with cardiovascular diseases including coronary artery disease, vitamin d and diastolic function, LV hypertrophy and systolic heart failure.

Even though diastolic LV dysfunction is an early manifestation of cardiac disease, there is no study that examines whether a deficiency of vitamin D is associated with LV diastolic dysfunction. Method A retrospective observational review of patients women was conducted to examine if low OH-vitamin D levels were associated with LV diastolic dysfunction. Results All the LV diastolic dysfunction parameters: Conclusions Despite growing medical literature suggesting vitamin D deficiency is associated with cardiovascular disease, in this present study there is no significant association of vitamin D levels and LV diastolic performance, including left atrial volume index.

There is no study that examines whether deficiency of Vitamin d and diastolic function D is associated with left ventricular diastolic dysfunction. The present study showed no significant vitamin d and diastolic function of Vitamin D levels and left ventricular diastolic performance, including left atrial volume index.

Vitamin D Vit D deficiency is highly prevalent and has been shown to be associated with cardiovascular diseases, including coronary artery disease, left ventricular LV hypertrophy and systolic heart failure. Since diastolic dysfunction is an early manifestation of LV hypertrophy and ventricular dysfunction, 89 it may reflect the effects of Vit D deficiency on the cardiovascular system.

As a result, the present study examines if there is any association between Vit D levels and diastolic dysfunction as measured by comprehensive two-dimensional 2D Doppler echocardiography.

A retrospective analysis of patients women from to who had an echocardiogram and a serum Vit D level performed. Patients were unselected and the specific reasons for obtaining Vit D levels and echocardiographic examination were not evaluated. The patients were divided into two groups: This classification of Vit D levels was in part based on the recommendations of the Institute of Medicine report.

We also run parathyroid hormone, pro-brain natriuretic peptide BNPtotal prostate-specific antigen and thyroid stimulating hormone on Cobas All demographic, clinical and echocardiographic measurements pertaining to LV diastolic function were compared between the two groups. Definition of abnormal diastolic dysfunction was based on the American and European Society of Echocardiography criteria grading system. Each participant underwent detailed transthoracic2D, and tissue Doppler imaging echocardiography performed with a GE instrument GE Healthcare, Milwaukee, vitamin d and diastolic function, Wisconsin, USA by standard techniques as described earlier, with participants in the left lateral decubitus position, vitamin d and diastolic function.

Echocardiograms were interpreted by American Society of Echocardiography board certified echocardiologists. Pulsed wave Doppler was performed in apical four-chamber view to obtain mitral inflow velocities. Pulsed wave Doppler imaging was performed in apical views to obtain tissue Doppler annular velocities. The data were summarised as means and SD for continuous variables. Using t vitamin d and diastolic function compared the means of echocardiographic continuous variables and Vit D levels among the groups.

When means were compared between more than two groups, one-way analysis of variance test was used. Any p vitamin d and diastolic function of less than 0. We also performed simple regression between echocardiographic parameters and Vit D level.

Since age, hypertension and concomitant Vit D therapy was different among the groups compared, we performed regression analysis adjusted for age, hypertension and Vit D therapy for Vit D level and echocardiographic parameters, vitamin d and diastolic function.

The mean Vit D level of the entire cohort was Overall mean LVMI was There was no symptoms and prostate cancer significant difference between groups 1 and 2 LV size measured as mean LV end diastolic dimension was Groups 1 and2 There was no statistically significant difference in mean between groups 1 and 2 Only measurement found to be significant between the groups was interventricular septal thickness Similarly, the mean DT was There were no statistically significant difference between groups 1 and 2 There was no statistically significant difference between groups 1 and 2 0.

We vitamin d and diastolic function not find any association between Vit D level and any echocardiographic parameters of LV diastolic dysfunction after adjusting for age, hypertension and concomitant Vit D therapy table 3.

We did not find any difference in mean Vit D levels in these groups too as shown in table 5. The main finding vitamin d and diastolic function this study is that Vit D levels measured in a temporal relationship to a comprehensive diagnostic echocardiogram with detailed examination of LV diastolic function showed no significant correlation with diastolic function, vitamin d and diastolic function.

To the best of our knowledge this is the first, large cross-sectional study attempting to examine any relationship between baseline Vit D levels and comprehensive echocardiography to study LV diastolic function. Vit D therapy has been reported to be associated with the reduction of LAV index and attenuation of a rise of BNP in patients with chronic kidney disease with mild-to-moderate LV hypertrophy.

These results were attenuated by multivariable analysis. Of note, the Hoorn study did not measure other diastolic parameters including tissue doppler measurements. Our cohort involved patients with hypertension and diabetes, both of which can influence LV mass and diastolic function.

If we had excluded diabetes and hypertension, then a major proportion of patients would have been excluded from the study limiting generalisability of our results. Other large studies have also included patients with these conditions at baseline.

However, it is very interesting to note that despite a higher proportion of patients with diabetics in group 1, none of diastolic parameters including LAVI a surrogate marker of long-term diastolic dysfunction were different between the study groups.

Our cohort also included patients with hypertension which is a well-known factor influencing both LV mass and diastolic dysfunction. It is also interesting to note that patients with a higher Vit D level were likely to be on Vit D replacement therapy and women, however, vitamin d and diastolic function, it did not affect diastolic dysfunction status as compared with lower Vit D level table 2. Predominalty female-elderly patients with Vit D sufficiency group who were on Vit D replacement therpay could have had a diagnosis of osteoporesis but we were not able to ascertain that because of retrospective design and limited data availability.

It is very common in the USA for patients to be on over the counter Vit D supplement therapy for preventive measures without having a diagnosis of osteoporesis. One might argue that Doppler diastolic parameters of LV diastolic dysfunction are subject to acute hemodynamic changes.

However, LAVI has been shown to be an excellent surrogate marker of long-term diastolic function, and correlates better as a sensitive parameter for diastology. Whether this is due to random chance or the first manifestation of Vit D deficiency is uncertain since no other echocardiographic parameter was different. There are several possible explanations for the lack of a relationship between Vit D levels and diastolic dysfunction.

The most important is the nature of a cross-sectional study. These were unselected patients who happen to have a Vit D level obtained in close proximity to a diagnostic echocardiogram. There is insufficient information to assess the duration of Vit D deficiency, although it is known that a Vit D level usually represents a duration of at least several weeks. We believe that the strength of our study is the large sample size representing patients across a broad age spectrum, vitamin d and diastolic function, and the proximity of the echocardiogram with the Vit D level.

One may argue that in our cohort, we did not look into difference in BNP, which could have supported our data in vitamin d and diastolic function of LV filling pressures. Since the fundamental measurements of diastolic dysfunction are mitral inflow velocities and tissue Doppler imaging which were not different between Vit D deficiency and normal Vit D levels, the addition of BNP data would probably have had limited or no additional value.

An additional strength of our study is that comprehensive echocardiography including detailed parameters of diastolic function was performed by a single core echocardiogram laboratory certified by the American Society of Echocardiography with echocardiography boarded certified cardiologists. Despite growing medical literature suggesting Vit D deficiency is associated with cardiovascular disease, in this present study involving a large number of unselected patients, Vit D deficiency is not associated with LV diastolic dysfunction and an abnormal LAV index.

There is a large ongoing prospective study with Vit D therapy which would help clarify the apparent relationship in the medical literature. Contributors HL conceived, designed, vitamin d and diastolic function, participated in data abstraction, analysis, interpretation and drafting of the manuscript. All authors approved the final manuscript. Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Provenance and peer review Not commissioned; externally peer reviewed.

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Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Latest content Archive Authors About. Log in via Institution. Heart failure and cardiomyopathies. Vitamin D levels and left ventricular diastolic function. Abstract Objective To determine the association between serum vitamin D level and left ventricular LV diastolic dysfunction.

Left ventricular diastolic dysfunction Vitamin D deficiency diastology Key messages Vitamin D deficiency is associated with various cardiovascular diseases. Introduction Vitamin D Vit D deficiency is highly prevalent and has been shown to be associated with cardiovascular diseases, including coronary artery disease, left ventricular LV hypertrophy and systolic heart failure.

Methodology Patient population A retrospective analysis of patients women from to who had vitamin d and diastolic function echocardiogram and a serum Vit D level performed. Echocardiography Each participant underwent detailed transthoracic2D, and tissue Doppler imaging echocardiography performed with a GE instrument GE Healthcare, Milwaukee, Wisconsin, USA by standard techniques as described earlier, with participants in the left lateral decubitus position.

Measurements of diastolic function Mitral inflow Pulsed wave Doppler was performed in apical four-chamber view to obtain mitral inflow velocities. Tissue Doppler annular velocities Pulsed wave Doppler imaging was performed in apical views to obtain tissue Doppler annular velocities.

Statistical analysis The data were summarised as means and SD for continuous variables. View inline View popup. Discussion The main finding of this study is that Vit D levels measured in a temporal relationship to a comprehensive diagnostic echocardiogram with detailed examination of LV diastolic function showed no significant correlation with diastolic function. Conclusion Despite growing medical literature suggesting Vit D deficiency is associated with cardiovascular disease, in this present study involving a large number of unselected patients, Vit D deficiency is not associated with LV diastolic vitamin d and diastolic function and an abnormal LAV index.

Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? J Am Coll of Cardiol ; Circulating hydroxy-vitamin D and risk of cardiovascular disease:

 

Vitamin d and diastolic function

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