Effect of vitamin D deficiency and supplementation on myocardial deformation parameters and epicardial fat thickness in patients free of cardiovascular risk

Abstract

Vitamin D deficiency is associated with impaired myocardial deformation parameters and cardiovascular disease (CVD). Increased epicardial fat thickness (EFT) is also associated with increased risk of CVD. The aim of the study is to evaluate the effect of vitamin D deficiency and supplementation on myocardial deformation parameters and EFT. The study population consisted of 50 patients with vitamin D deficiency who were free of cardiovascular risk (mean age: 42.6 ± 8.9 years, 37 female). Patients were treated with oral administration of vitamin D3. Myocardial deformation parameters and EFT were evaluated before and after treatment of those patients. Vitamin D levels significantly increased after treatment (30.5 ± 10.5 vs. 9.9 ± 5.3 nmol/l, p < 0.001). There was no significant difference between conventional echocardiographic parameters before and after treatment. Baseline EFT was significantly higher than post-treatment measurements (35.2 ± 8.0 vs. 27.5 ± 5.6 mm, p < 0.001). Post-treatment myocardial deformation parameters were also significantly higher than baseline measurements. Baseline vitamin D levels correlated with baseline EFT and left ventricular global longitudinal strain (LV-GLS). Post-treatment vitamin D levels also correlated with post-treatment EFT, body mass index, and LV-GLS. Baseline vitamin D level was an independent predictor of baseline LV-GLS (p = 0.002). Patients with impaired LV-GLS had significantly lower vitamin D levels than patients with normal LV-GLS (6.6 ± 3.8 vs. 11.0 ± 5.3 nmol/l, p = 0.005). Baseline vitamin D level was also an independent predictor of baseline impaired LV-GLS (p = 0.010). Vitamin D supplementation has beneficial effects on myocardial deformation parameters and EFT. Moreover, baseline vitamin D levels are a predictor of impaired LV-GLS.

Is the longitudinal deformation of the left ventricle affected by vitamin D deficiency in nondiabetics? A 2D speckle‐tracking echocardiographic study

“…Such reasoning can be applied to the other common pathways of myocardial injuries such as lipid accumulation in the myocardium, 4,21 matrix metalloproteinase activation, 22,23 and oxidative stress. 24 Sunbul et al 9 In other related studies on the LV function using indices other than the conventional echocardiographic ones, tissue Doppler imaging was utilized to evaluate the LV diastolic function and to measure e′. 25,26 This method is angle-dependent, and e′ only shows the velocity of the myocardium.…”

“…5,6 Our knowledge regarding the effects of vitamin D deficiency on the deformation of the myocardium (as an index of the myocardial function) in various cardiac chambers is very limited; what we do know, however, is that vitamin D deficiency does not necessarily lead to the impairment of the functions of the cardiac chambers. 9 Two-dimensional speckle-tracking echocardiography (2DSTE) is an accepted imaging modality for the detection of subtle LV myocardial impairment 10 in various situations such as metabolic conditions (eg, liver disease), 11,12 subclinical thyroid diseases, 13,14 and blood glucose level control in diabetic patients. In the other study, the effects of vitamin D administration were evaluated on the LV systolic deformation without comparing the results with those in a control group.…”

“…In the other study, the effects of vitamin D administration were evaluated on the LV systolic deformation without comparing the results with those in a control group. 9 Two-dimensional speckle-tracking echocardiography (2DSTE) is an accepted imaging modality for the detection of subtle LV myocardial impairment 10 in various situations such as metabolic conditions (eg, liver disease), 11,12 subclinical thyroid diseases, 13,14 and blood glucose level control in diabetic patients. 15 Hypothesizing that the longitudinal deformation of the LV myocardium in systole and diastole is affected by vitamin D deficiency in nondiabetics, we drew upon 2DSTE to evaluate this index in nondiabetic subjects without significant epicardial coronary artery stenosis.…”

Nonalcoholic Steatohepatitis Score is an Independent Predictor of Right Ventricular Dysfunction in Patients with Nonalcoholic Fatty Liver Disease

“…Novel techniques such as two-dimensional (2D) speckle-tracking echocardiography (STE) provide a global approach to LV and RV myocardial mechanics, giving information about the three spatial dimensions of myocardial deformation. Previous studies have shown that 2D STE can help us to evaluate LV and RV function in several systemic diseases [13][14][15][16][17]. There is a close relationship between NAFLD and impaired LV function [18].…”

Evaluation of right and left heart mechanics in patients with chronic thromboembolic pulmonary hypertension before and after pulmonary thromboendarterectomy

“…Two-dimensional (2D) speckle tracking echocardiography (STE) is an advanced method that provides an objective quantification of myocardial function [4]. Although it has often been used to assess LV function, to date it has rarely been used for evaluation of RV and atrial functions [5][6][7]. Previous studies have demonstrated that 2D STE is a useful method for the evaluation of LV function in CTEPH patients before and after PTE [8].…”