Related Experiment Video
Updated: Jul 19, 2025
Measuring Cardiac Autonomic Nervous System ANS Activity in Children
Published on: April 29, 2013
Relationship Between Vitamin D Level and Index of CardioElectrophysiological Balance in Children
Ahmet Guzelcicek1, Emrullah Kilinc1, Halil Fedai2
1Department of Pediatrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey.
Insights
Children with low vitamin D levels show increased index of cardio-electrophysiological balance (iCEB) and correct cardioelectrophysiological balance (iCEBc) values. These electrocardiographic parameters may help predict ventricular arrhythmia risk in pediatric vitamin D deficiency.
Area of Science:
- Pediatric Cardiology
- Endocrinology
- Cardiovascular Electrophysiology
Background:
- Vitamin D deficiency is linked to cardiovascular issues like hypertension and heart failure.
- Electrocardiographic (ECG) parameters are used to predict ventricular arrhythmias.
- Index of cardio-electrophysiological balance (iCEB) and correct cardioelectrophysiological balance (iCEBc) are novel ECG parameters for arrhythmia prediction.
Purpose of the Study:
- To examine the association between vitamin D deficiency and iCEB/iCEBc values in children.
- To assess the utility of iCEB and iCEBc as potential biomarkers in pediatric vitamin D deficiency.
Main Methods:
- 186 children were categorized into three groups based on vitamin D levels (<20 ng/ml, 21-29 ng/ml, >30 ng/ml).
- 12-lead ECGs were obtained to calculate iCEB and iCEBc values.
- Statistical analyses, including correlation and regression, were performed to compare groups and identify predictors.
Main Results:
- Significant differences in QT, QTc, QT/QRS, and QTc/QRS were observed between groups (p<0.05).
- A negative correlation was found between vitamin D levels and QT/QRS and QTc/QRS ratios (p<0.001).
- Vitamin D level emerged as an independent predictor of QTc/QRS in multivariate analysis (p<0.001).
Conclusions:
- iCEB and iCEBc parameters are significantly elevated in children with lower vitamin D levels.
- These ECG parameters may aid in monitoring ventricular arrhythmia risk in pediatric vitamin D deficiency.
- iCEBc offers a practical, non-invasive method for clinical assessment.
Background:
Vitamin D deficiency has been found to be associated with various cardiovascular disorders, including hypertension, coronary artery disease, heart failure, peripheral vascular diseases, and sudden cardiac death. In the literature, it has been reported that many electrocardiographic parameters have been developed to predict ventricular arrhythmias. In recent studies, it is noteworthy that the index of cardio-electrophysiological balance (iCEB) and correct cardioelectrophysiological balance (iCEBc), which are electrocardiographic parameters, can be used as new, easy, cheap and non-invasive parameters to predict ventricular arrhythmias.
Objective:
This study aimed to investigate the relationship between vitamin D deficiency and iCEB and iCEBc values in children.
Methods:
A total of 186 patients were included in this study. Group 1 included 114 patients with vitamin D levels below 20 ng/ml; 50 patients with vitamin D levels of 21-29 ng/ml were included in Group 2; Group 3 consisted of 36 patients with a vitamin D level above 30 ng/ml. iCEB and iCEBc values were calculated by taking 12-lead ECG from all individuals and comparing them between groups.
Results:
A total of 186 children, 114 subjects in Group 1, 36 subjects in Group 2, and 36 subjects in Group 3, were included in the study. Demographic characteristics and height-weight values of the groups were similar. Significant differences were found between the groups in terms of QT, QTc, QT/QRS, and QTc/QRS levels (p: 0.003, 0.028, 0.001, and 0.001, respectively). In the correlation analysis, a negative correlation was found between QTc/QRS and vitamin D level (r=-0.320, p=<0.001) and between QT/QRS and vitamin D level (r=-0.268, p=<0.001). Moreover, vitamin D level (β=0.389, p<0.001) was determined as an independent predictor of QTc/QRS in multivariate logistic regression analysis.
Conclusion:
iCEB and iCEBc parameters increase significantly in children with low vitamin D levels. These parameters are also evaluated during the follow-up of children with vitamin D deficiency in terms of the risk of ventricular arrhythmia. iCEBc can be used as an easy, inexpensive, non-invasive, and reproducible parameter.
More Related Videos
08:12Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions
Published on: June 5, 2019
10:21Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test
Published on: September 22, 2023
Related Concept Videos
01:25Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
01:23Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...