Hypovitaminosis D and Valvular Calcification in Patients With Dilated Cardiomyopathy

Dishmon, Dwight A.; Dotson, Jimmy L.; Nelson, M. D.; Weber, Karl T.; Ahmad, Mahmood; Bhattacharya, Syamal K.; D’Cruz, Ivan A.; Davis, Richard C.

doi:10.1097/maj.0b013e3181907add

Cited by 8 publications

(6 citation statements)

References 39 publications

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“…Dishmon et al reported an association between vitamin D deficiency and echocardiographic evidence of valvular calcium in a small sample of patients with dilated cardiomyopathy. 18 Similar to our findings, prior work in MESA revealed an inverse association between serum 25(OH)D and the risk of incident CAC by cardiac CT. 7 Interestingly, MAC and CAC have been shown to share the same traditional CVD risk factors, 19,20 and given the strong association between MAC and CAC, 21 the same biological mechanisms may underlie both diseases.…”

Section: Discussionsupporting

confidence: 91%

Relation of Serum Vitamin D to Risk of Mitral Annular and Aortic Valve Calcium (from the Multi-Ethnic Study of Atherosclerosis)

Tibuakuu

Zhao

Güallar

et al. 2017

The American Journal of Cardiology

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Serum 25(OH)D concentration has been identified as a possible modifiable risk factor for cardiovascular disease (CVD). We hypothesized that serum 25(OH)D concentration would be associated with calcifications of the left-sided heart valves, which are markers of CVD risk. Aortic Valve Calcium (AVC) and Mitral Annular Calcium (MAC) were quantified from cardiac CT scans performed on 5,530 MESA participants at the baseline exam (2000–2002) and at a follow-up visit at either Exam 2 (2002–2004) or Exam 3 (2004–2005). 25(OH)D was measured from serum samples collected at the baseline exam. Using relative risk regression, we evaluated the multivariable-adjusted risk of prevalent and incident AVC and MAC in this ethnically diverse population free of clinical CVD at baseline. The mean age of participants was 62±10 years; 53% were women, 40% white, 26% black, 21% Hispanic and 12% Chinese. Prevalent AVC and MAC were observed in 12% and 9%, respectively. There were no significant associations between 25(OH)D and prevalent AVC or MAC. Over a mean follow-up of 2.5 years, 4% developed incident AVC and 5% developed incident MAC. After adjusting for demographic variables, each 10 ng/ml higher serum 25(OH)D was associated with a 15% [RR=0.85 (95% CI 0.74, 0.98)] lower risk of incident MAC but not AVC. However, this association was no longer significant after adjusting for lifestyle and CVD risk factors. Results suggest a possible link between serum 25(OH)D and the risk for incident MAC, but future studies with longer follow-up are needed to further test this association.

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Section: Discussionsupporting

confidence: 91%

Relation of Serum Vitamin D to Risk of Mitral Annular and Aortic Valve Calcium (from the Multi-Ethnic Study of Atherosclerosis)

Tibuakuu

Zhao

Güallar

et al. 2017

The American Journal of Cardiology

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“…Under epidemic concern among US veterans of Vitamin D deficiency which linked to many cardiovascular abnormalities, Joshi et al retrospectively reviewed the data for this condition, largely represented by low levels of 25-hydroxy vitamin D, and the significantly associated echocardiographic findings of pulmonary hypertension and valvular problems (mitral regurgitation & aortic sclerosis). This is consistent with previous evidences [15]. In recent years, the literature has exploded with interest surrounding vitamin D and its potential effects on the cardiovascular system [16].…”

supporting

confidence: 92%

Advances in the Management of Valvular Heart Disease

McCullough¹

2013

J Clin Exp Cardiolog

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“…Several epidemiological studies measuring serum 25(OH)D demonstrate no association with presence or extent of CAC or MAC [ 86 , 87 ], although after three years low serum 25(OH)D was associated with new CAC development, but not CAC progression [ 88 ]. There is often an inverse association with calcification presence in those with previously diagnosed disease, such as CKD [ 89 , 90 ], type 1 diabetes [ 91 ] or dilated cardiomyopathy [ 92 ], where a serum 25(OH)D concentration of ≥75 nmol/L is protective. Likewise with respect to serum 1,25(OH)2D, some studies show no association with CAC extent or progression [ 87 , 93 ], although in subjects at risk for CHD, serum 1,25(OH)2D was inversely correlated with the extent of calcification [ 94 ].…”

Section: Vitamin Dmentioning

confidence: 99%

A Review of the Effect of Diet on Cardiovascular Calcification

Nicoll

Howard²,

Henein

2015

IJMS

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Cardiovascular (CV) calcification is known as sub-clinical atherosclerosis and is recognised as a predictor of CV events and mortality. As yet there is no treatment for CV calcification and conventional CV risk factors are not consistently correlated, leaving clinicians uncertain as to optimum management for these patients. For this reason, a review of studies investigating diet and serum levels of macro- and micronutrients was carried out. Although there were few human studies of macronutrients, nevertheless transfats and simple sugars should be avoided, while long chain ω-3 fats from oily fish may be protective. Among the micronutrients, an intake of 800 μg/day calcium was beneficial in those without renal disease or hyperparathyroidism, while inorganic phosphorus from food preservatives and colas may induce calcification. A high intake of magnesium (≥380 mg/day) and phylloquinone (500 μg/day) proved protective, as did a serum 25(OH)D concentration of ≥75 nmol/L. Although oxidative damage appears to be a cause of CV calcification, the antioxidant vitamins proved to be largely ineffective, while supplementation of α-tocopherol may induce calcification. Nevertheless other antioxidant compounds (epigallocatechin gallate from green tea and resveratrol from red wine) were protective. Finally, a homocysteine concentration >12 µmol/L was predictive of CV calcification, although a plasma folate concentration of >39.4 nmol/L could both lower homocysteine and protect against calcification. In terms of a dietary programme, these recommendations indicate avoiding sugar and the transfats and preservatives found in processed foods and drinks and adopting a diet high in oily fish and vegetables. The micronutrients magnesium and vitamin K may be worthy of further investigation as a treatment option for CV calcification.

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Hypovitaminosis D and Valvular Calcification in Patients With Dilated Cardiomyopathy

Cited by 8 publications

References 39 publications

Relation of Serum Vitamin D to Risk of Mitral Annular and Aortic Valve Calcium (from the Multi-Ethnic Study of Atherosclerosis)

Relation of Serum Vitamin D to Risk of Mitral Annular and Aortic Valve Calcium (from the Multi-Ethnic Study of Atherosclerosis)

Advances in the Management of Valvular Heart Disease

A Review of the Effect of Diet on Cardiovascular Calcification

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