[Parathormone and vitamin d in heart failure - theoretical influence on disease development and potential therapy...

Vitamin D and parathormone (PTH) are hormones regulating calcium and phosphorus homeostasis. The aim of the article is to summarize the current knowledge in the field and to assess its impact on heart failure (HF) pathogenesis. PTH serum concentration being frequently elevated in patients with HF has negative impact on circulatory system stimulating myocardial fibrosis, wall thickening and reninangiotensin-aldosterone system (RAAS) activity. PTH reacts with smooth muscle cells receptors mediating adrenergic and chronotropic activation resulting in increased oxidative stress, endothelial dysfunction, intracellular calcium overload and has negative influence on prognosis in chronic HF patients. Vitamin D, which deficiency is common in developed countries, has widely distributed receptors including myocardium, endothelium and smooth muscle cells. Being an antiproliferative agent vitamin D modulates RAAS, regulates natriuretic peptides and myosine expression, suppresses inflammatory cytokines activity, has antiarrhytmic properties and increases myocardial contractility. It decreases arterial pressure, inhibits atherosclerosis progression and plays a protective role against inflammation including viral infections of cardiotropic potential. Optimal vitamin D serum concentration has potential protective impact on cardiovascular system.