Does Vitamin D Deficiency Effect Heart Rate Variability in Low Cardiovascular Risk Population?

Ahmet Nalbant, Mehmet Bulent Vatan, Perihan Varım, Ceyhun Varım, Tezcan Kaya, Ali Tamer, Ahmet Nalbant, Mehmet Bulent Vatan, Perihan Varım, Ceyhun Varım, Tezcan Kaya, Ali Tamer

Abstract

Aim: This study aimed to evaluate the cardiac autonomic dysfunction and the cardiac arrhythmia risk using heart rate variability parameters in subjects with vitamin D deficiency and low cardiovascular risk.

Material and methods: One hundred five consecutive individuals, 54 patients with low vitamin D status and 51 healthy controls were enrolled in this study. The overall cardiac autonomic tone was quantified by using various heart rate variability parameters included mean RR interval, mean Heart Rate, mean of standard deviations of intervals for 24 hours (SDNN), standard deviation of averages of intervals (SDANN), mean of standard deviation of intervals for 5 minutes (SDNNI), root mean square of difference of successive intervals (rMSSD) and the proportion of intervals differing more than 50 ms (pNN50) values. The 12-lead ECG was recorded from each participant, and QT intervals were measured.

Results: Baseline demographic profiles were similar between two groups. The heart rate variability parameters such as mean RR interval, mean HR, SDNN, SDANN, SDNNI, rMSSD and pNN50 (%) values were not significantly different in patients with low vitamin D status compared to control group. The electrocardiography analysis revealed only slight but significant prolongation of corrected QT (QTc) intervals in the control group.

Conclusion: HRV variables were not significantly altered in patients with vitamin D deficiency in low cardiovascular risk profile group. Further studies evaluating these findings in other cohorts with high cardiovascular risk are required.

Keywords: Autonomic dysfunction; heart rate variability; sudden cardiac death; vitamin D deficiency.

References

    1. Peterlik M, Cross HS. Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur J Clin Invest. 2005;35:290–304. . PMid:15860041.
    1. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117:503–11. . PMid:18180395. PMCid:PMC2726624.
    1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81. . PMid:17634462.
    1. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. The prevalence of cardiovascular risk factors and the serum levels of vitamin D in the United States: data from the NHANES III. Arch Intern Med. 2007;167:1159–65. . PMid:17563024.
    1. Gaddipati VC, Bailey BA, Kuriacose R, Copeland RJ, Manning T, Peiris AN. The relationship of vitamin D status to cardiovascular risk factors and amputation risk in veterans with peripheral arterial disease. J Am Med Dir Assoc. 2011;12:58–61. . PMid:21194661.
    1. Xiang W, Kong J, Chen S, Cao LP, Qiao G, Zheng W, et al. Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin-angiotensin systems. Am J Physiol Endocrinol Metab. 2005;288:125–132. . PMid:15367398.
    1. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxy vitamin D is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110:229–38. .
    1. Riachy R, Vandewalle B, Moerman E, Belaich S, Lukowiak B, Gmyr V, Muharram G, et al. 1,25- Dihydroxyvitamin D3 protects human pancreatic islets against cytokine-induced apoptosis via down-regulation of the Fas receptor. Apoptosis. 2006;11(2):151–9. . PMid:16502254.
    1. Mitsuhashi T, Morris RC, Jr, Ives HE. 1,25-dihydroxyvitamin D3 modulates growth of vascular smooth muscle cells. J Clin Invest. 1991;87:1889–95. . PMid:1645744. PMCid:PMC296939.
    1. Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83:754–9. PMid:16600924.
    1. Kim HW, Park CW, Shin YS, Kim YS, Shin SJ, Choi EJ, et al. Calcitriol regresses cardiac hypertrophy and qt dispersion in secondary hyperparathyroidism on hemodialysis. Nephron Clin Pract. 2006;102:21–9. . PMid:16166802.
    1. Tishkoff DX, Nibbelink KA, Holmberg KH, Dandu L, Simpson RU. Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility. Endocrinology. 2008;149:558–64. . PMid:17974622. PMCid:PMC2219302.
    1. Deo R, Katz R, Shlipak MG, Sotoodehnia N, Psaty BM, Sarnak MJ, et al. Vitamin D parathyroid hormone, and sudden cardiac death: results from the Cardiovascular Health Study. Hypertension. 2011;58(6):1021–8. . PMid:22068871. PMCid:PMC3337033.
    1. Mann MC, Exner DV, Hemmelgarn BR, Sola DY, Turin TC, Ellis L, et al. Vitamin D levels are associated with cardiac autonomic activity in healty humans. Nutrients. 2013;5:2114–27. . PMid:23752493. PMCid:PMC3725496.
    1. Drechsler C, Pilz S, Obermayer-Pietsch B, Verduijn M, Tomaschitz A, Krane V, et al. Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients. Eur Heart J. 2010;31:2253–61. . PMid:20688781. PMCid:PMC2938469.
    1. John C A, Thomas BJ, Breithardt G, Cerutti S, Cohen RJ, Coumel P, et al. Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology. Heart rate variability. Eur Heart J. 1996;17:354–81. .
    1. Tsuji H, Larson MG, Venditti FJ, Jr, Manders ES, Evans JC, Feldman CL, et al. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation. 1996;94(11):2850–5. . PMid:8941112.
    1. Kleiger RE, Stein PK, Bigger JT. Heart rate variability: Measurement and clinical utility. Ann Noninvasive Electrocardiol. 2005;10:88–101. . PMid:15649244.
    1. Tak YJ, Lee JG, Kim YJ, Lee SY, Cho BM. 25-hydroxyvitamin D and its relationship with autonomic dysfunction using time- and frequency-domain parameters of heart rate variability in Korean populations: a cross-sectional study. Nutrients. 2014;6(10):4373–88. . PMid:25325256. PMCid:PMC4210923.
    1. Koizumi K, Terui N, Kollai M. Effect of cardiac vagal and sympathetic nerve activity on heart rate in rhythmic fluctuations. J Auton Nerv Syst. 1985;12:251–9. .
    1. Sasaki K, Maruyama R. Consciously controlled breathing decreases the high-frequency component of heart rate variability by inhibiting cardiac parasympathetic nerve activity. Tohoku J Exp Med. 2014;233(3):155–63. . PMid:24965685.
    1. Bodyak N, Ayus JC, Achinger S, Shivalingappa V, Ke Q, Chen YS, et al. Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in dahl salt- sensitive animals. Proc Natl Acad Sci U S A. 2007;104:16810–5. . PMid:17942703. PMCid:PMC2040477.
    1. Beard CM, Fuster V, Elveback LR. Daily and seasonal variation in sudden cardiac death, Rochester, Minnesota, 1950–1975. Mayo Clin Proc. 1982;57:704–6. PMid:7132431.
    1. Peckova M, Fahrenbruch CE, Cobb LA, Hallstrom AP. Weekly and seasonal variation in the incidence of cardiac arrests. Am Heart J. 1999;137:512–5. .
    1. Zittermann A, Schleithoff SS, Koerfer R. Vitamin D and vascular calcification. Curr Opin Lipidol. 2007;18:41–6. . PMid:17218831.
    1. Kloner RA, Poole WK, Perritt RL. When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220,000 cases. Circulation. 1999;100:1630–4. . PMid:10517734.
    1. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67:373–8. . PMid:2839537.
    1. Corr PB, Yamada KA, Witkowski FX, Fozzard HA, Haber E, Jennings RB, et al. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. The heart and cardiovascular system. New York, NY: Raven Press; 1986. p. 1343.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner