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Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?
Armin Zittermann1, Stefanie Schulze Schleithoff, Gero Tenderich
1Department of Nutrition Science, University of Bonn, Germany. a.zittermann@uni-bonn.de
Insights
Low vitamin D status is linked to congestive heart failure (CHF) pathogenesis. Reduced vitamin D metabolites (25-hydroxyvitamin D and calcitriol) correlate with CHF severity, suggesting a role in myocardial dysfunction and mineral metabolism alterations.
Area of Science:
- Cardiology
- Endocrinology
- Nutritional Science
Background:
- Impaired intracellular calcium metabolism is implicated in congestive heart failure (CHF) pathogenesis.
- The precise etiology of CHF remains incompletely understood.
- Vitamin D's role in cardiovascular health is an area of ongoing research.
Purpose of the Study:
- To investigate the association between vitamin D status and congestive heart failure (CHF).
- To explore the relationship between vitamin D metabolites and markers of CHF severity.
Main Methods:
- Study included 54 patients with CHF (divided by age <50 and >/=50 years) and 34 age-matched controls.
- Measured serum levels of N-terminal pro-atrial natriuretic peptide (NT-proANP), vitamin D metabolites (25-hydroxyvitamin D, calcitriol), and calcium metabolism parameters.
- Blood samples were collected during winter months (November 2000–March 2001).
Main Results:
- CHF patients exhibited significantly elevated NT-proANP and serum phosphorus levels.
- Reduced circulating levels of 25-hydroxyvitamin D and calcitriol were observed in CHF patients.
- Lowered calcium and elevated parathyroid hormone levels were noted in younger CHF patients; parathyroid hormone tended to be higher in elderly CHF patients.
- Inverse correlations were found between 25-hydroxyvitamin D/calcitriol and NT-proANP, indicating lower vitamin D with higher CHF severity.
Conclusions:
- Low vitamin D status may contribute to altered mineral metabolism and myocardial dysfunction in CHF patients.
- Vitamin D deficiency could be a contributing factor in the pathogenesis of congestive heart failure.
- Further research is warranted to elucidate the therapeutic potential of vitamin D supplementation in CHF management.
Objectives:
This study was designed to evaluate the association between vitamin D status and congestive heart failure (CHF).
Background:
Impaired intracellular calcium metabolism is an important factor in the pathogenesis of CHF. The etiology of CHF, however, is not well understood.
Methods:
Twenty patients age <50 years and 34 patients age >/=50 years with New York Heart Association classes >/=2 and 34 control subjects age >/=50 years were recruited. N-terminal pro-atrial natriuretic peptide (NT-proANP), a predictor of CHF severity; vitamin D metabolites; and parameters of calcium metabolism were measured in fasting blood samples collected between November 2000 and March 2001.
Results:
Both groups of CHF patients had markedly increased serum levels of NT-proANP (p < 0.001), increased serum phosphorus levels (p < 0.001), and reduced circulating levels of both 25-hydroxyvitamin D (p < 0.001) and calcitriol (p < 0.001). Albumin-corrected calcium levels were reduced and parathyroid hormone levels were increased in the younger CHF patients compared with the controls (both p values <0.001). Moreover, parathyroid hormone levels tended to be higher in the elderly CHF patients than in the controls (p = 0.074). In a nonlinear regression analysis 25-hydroxyvitamin D and calcitriol were inversely correlated with NT-proANP (r(2) = 0.16; p < 0.001 and r(2) = 0.12; p < 0.01, respectively). The vitamin D genotype at the BmsI restriction site did not differ between the study groups.
Conclusions:
The low vitamin D status can explain alterations in mineral metabolism as well as myocardial dysfunction in the CHF patients, and it may therefore be a contributing factor in the pathogenesis of CHF.