Related Experiment Video
Updated: Sep 3, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Vitamin D Levels in Black Americans and the Association With Left Ventricular Remodeling and Incident Heart Failure
Daisuke Kamimura1, Wondwosen K Yimer2, Amil M Shah3
1Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Insights
Lower vitamin D3 levels are linked to heart changes and increased risk of heart failure with preserved ejection fraction (HFpEF) in Black Americans. This highlights a potential role for vitamin D3 in cardiovascular health for this population.
Area of Science:
- Cardiovascular Medicine
- Nutritional Science
- Epidemiology
Background:
- Lower serum vitamin D3 concentrations are linked to increased cardiovascular disease risk.
- Vitamin D3 deficiency is more prevalent in Black Americans.
- Associations between vitamin D3 levels and left ventricular (LV) structure/function, particularly HFpEF, are not well-established in Black Americans.
Purpose of the Study:
- To investigate the association between serum vitamin D3 levels and LV structure and function.
- To examine the relationship between serum vitamin D3 levels and incident heart failure (HF), specifically HFpEF, in Black Americans.
Main Methods:
- Analysis of 5306 Black Americans from the Jackson Heart Study cohort.
- Echocardiography used to assess LV structure and function.
- Incident HF hospitalizations were categorized as HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF).
- Statistical adjustments for potential confounding factors were performed.
Main Results:
- Lower vitamin D3 levels were associated with greater LV relative wall thickness.
- Higher serum vitamin D3 levels were associated with a decreased hazard for overall HF.
- This protective association was primarily driven by a significant reduction in the hazard for HFpEF.
Conclusions:
- Lower serum vitamin D3 levels are associated with LV concentric remodeling and increased risk of HF, particularly HFpEF, in Black Americans.
- Further research is needed to determine if vitamin D3 supplementation can prevent LV remodeling and HFpEF in this population.
Background:
In observational studies, a lower serum vitamin D3 concentration has been associated with an increased risk of cardiovascular disease. However, the associations between serum vitamin D3 levels and left ventricular (LV) structure and heart failure with preserved ejection fraction (HFpEF) have not been well-characterized among Black Americans. The prevalence of vitamin D3 deficiency is higher among Black Americans than in other race/ethnicity groups. We hypothesized that serum vitamin D3 levels are associated with LV concentric remodeling and incident HFpEF in Black Americans.
Methods And Results:
Among 5306 Black Americans in the Jackson Heart Study cohort, we investigated the relationships between serum vitamin D3 levels and LV structure and function, evaluated with echocardiography, and incident HF hospitalization, categorized as either HF with reduced EF (HFrEF; an EF of <50%) or HFpEF (an EF of ≥50%). After adjustment for possible confounding factors, lower vitamin D3 levels were associated with greater relative wall thickness (β for 1 standard deviation [SD] increase -0.003, 95% confidence interval -0.005 to -0.000). Over a median follow-up period of 11 years (range 10.2-11.0 years), 340 participants developed incident HF (7.88 cases per 1000 person-years), including 146 (43%) HFrEF and 194 (57%) HFpEF cases. After adjustment, higher serum vitamin D3 levels were associated with decreased hazard for HF overall (hazard ratio for 1 SD increase 0.88, 95% confidence interval 0.78-0.99) driven by a significant association with HFpEF (hazard ratio for 1 SD increase 0.84, 95% confidence interval 0.71-0.99).
Conclusions:
In this community-based Black American cohort, lower serum vitamin D3 levels were associated with LV concentric remodeling and an increased hazard for HF, mainly HFpEF. Further investigation is required to examine whether supplementation with vitamin D3 can prevent LV concentric remodeling and incident HFpEF in Black Americans.
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