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Impaired cardiac autonomic functions in apparently healthy subjects with vitamin D deficiency
Uğur Canpolat1, Fırat Özcan1, Özcan Özeke1
1Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Insights
Vitamin D deficiency impairs cardiac autonomic function, as shown by reduced heart rate recovery and altered heart rate variability. This occurs even without obvious heart problems, suggesting a link between low vitamin D and cardiovascular health.
Area of Science:
- Cardiology
- Endocrinology
- Nutritional Science
Background:
- Vitamin D deficiency impacts cardiovascular health through various pathways.
- Limited research exists on cardiac autonomic dysfunction in individuals with vitamin D deficiency.
Purpose of the Study:
- To assess cardiac autonomic functions using heart rate recovery index (HRRI) and heart rate variability (HRV) in healthy subjects with vitamin D deficiency.
Main Methods:
- 24 vitamin D deficient and 50 vitamin D sufficient healthy participants were enrolled.
- Treadmill exercise tests and 24-hour Holter recordings were used to evaluate cardiac autonomic functions.
- HRRIs were calculated by subtracting recovery heart rates from maximal heart rate.
Main Results:
- Vitamin D deficient individuals exhibited significantly lower HRRIs and decreased HRV parameters (SDNN, SDANN, RMSSD, PNN50, HF).
- Conversely, vitamin D deficiency was associated with higher LF and LF/HF ratios.
- Serum 25(OH)D levels positively correlated with HRRIs and certain HRV metrics, and negatively with others.
Conclusions:
- Cardiac autonomic functions are impaired in vitamin D deficiency, even without apparent cardiac symptoms.
- Further research is necessary to understand the prognostic significance and clinical implications of these findings.
Objectives:
Vitamin D (VitD) deficiency affects the cardiovascular system via endocrine, paracrine, and autocrine pathways. Limited data are available regarding cardiac autonomic dysfunction in VitD deficiency. The aim of this study was to assess the cardiac autonomic functions by using heart rate recovery index (HRRI) and heart rate variability (HRV) in apparently healthy subjects with VitD deficiency.
Methods:
A total of 24 VitD deficient and 50 age-, gender-, and body mass index-matched VitD sufficient healthy participants who admitted to outpatient clinics at a tertiary centre were enrolled. All study participants underwent Treadmill exercise test and 24-hour Holter recording to assess cardiac autonomic functions. HRRIs were calculated by subtracting first, second, and third minute heart rates during recovery period from maximal heart rate.
Results:
Mean HRR1 (28.0 ± 8.3 vs 42.8 ± 6.4, P < 0.001), HRR2 (41.1 ± 11.2 vs 60.8 ± 10.4, P < 0.001), and HRR3 (44.9 ± 13.3 vs 65.9 ± 9.8, P < 0.001) were significantly higher in VitD sufficient group compared to VitD deficient group. HRV parameters as, SDNN (P = 0.040), SDANN (P < 0.001), RMSSD (P < 0.001), PNN50 (P < 0.001), and HF (P < 0.001) were significantly decreased in patients with VitD deficiency; but LF (P < 0.001) and LF/HF (P = 0.003) were significantly higher in VitD deficient group. Serum 25(OH)D level was positively correlated with HRRIs (P < 0.001), PNN50, RMSSD, SDANN, and HFnu; negatively correlated with LFnu and LF/HF (P < 0.05). Also, multivariate linear regression analysis showed that serum 25(OH)D level was significantly associated with HRRIs and HRV parameters (P < 0.001).
Conclusion:
Our study results suggest that cardiac autonomic functions are impaired in patients with VitD deficiency despite the absence of overt cardiac involvement and symptoms. Further studies are needed to elucidate the prognostic significance and clinical implications of impaired autonomic functions in patients with VitD deficiency.
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