Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?

Zittermann, Armin; Schleithoff, Stefanie Schulze; Tenderich, Gero; Berthold, Heiner K.; Körfer, Reiner; Stehle, Peter

doi:10.1016/s0735-1097(02)02624-4

Cited by 484 publications

(324 citation statements)

References 36 publications

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“…However, one would expect excessive diuresis to lower serum calcium concentration and activate parathyroid hormone, which enhances the absorption of calcium in the intestine by increasing the production of activated vitamin D 39. Despite the complex interactions of diuretics on calcium, vitamin D, and parathyroid hormone, our results are similar to what is found in humans with cardiovascular disease 4, 14, 15, 16…”

Section: Discussionsupporting

confidence: 83%

“…Knockout mouse data are even more convincing because vitamin D receptor knockout mice develop typical signs of CHF, such as cardiac hypertrophy, hypertension, and increased concentrations of atrial natriuretic peptide 12. In large epidemiologic studies in humans, with rare exceptions,13 most groups of CHF patients studied have shown insufficient or below reference range limits serum concentrations of 25‐hydroxyvitamin D [25(OH)D], the best indicator of an individual's vitamin D status 14, 15, 16. In a study by Zimmerman et al, for example, adults with CHF had 34% lower 25(OH)D concentrations than healthy subjects 17.…”

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confidence: 99%

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Relation of Vitamin D Status to Congestive Heart Failure and Cardiovascular Events in Dogs

Kraus

Rassnick

Wakshlag

et al. 2013

Veterinary Internal Medicne

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BackgroundVitamin D plays a pivotal role in cardiac function, and there is increasing evidence that vitamin D deficiency is associated with the development of congestive heart failure (CHF) in people.HypothesisSerum vitamin D concentration is lower in dogs with CHF compared with unaffected controls and serum vitamin D concentration is associated with clinical outcome in dogs with CHF.AnimalsEighty‐two client‐owned dogs.MethodsIn this cross‐sectional study, we examined the association between circulating 25‐hydroxyvitamin D [25(OH)D], a measure of vitamin D status, and CHF in dogs. In the prospective cohort study, we examined whether 25(OH)D serum concentration was associated with clinical outcome in dogs with CHF.ResultsMean 25(OH)D concentration (100 ± 44 nmol/L) in 31 dogs with CHF was significantly lower than that of 51 unaffected dogs (123 ± 42 nmol/L; P = .023). The mean calculated vitamin D intake per kg of metabolic body weight in dogs with CHF was no different from that of unaffected dogs (1.37 ± 0.90 μg/kg metabolic body weight versus 0.98 ± 0.59 μg/kg body weight, respectively, P = .097). There was a significant association of serum 25(OH)D concentration on time to clinical manifestation of CHF or sudden death (P = .02).Conclusion and Clinical RelevanceThese findings suggest that low concentrations of 25(OH)D may be a risk factor for CHF in dogs. Low serum 25(OH)D concentration was associated with poor outcome in dogs with CHF. Strategies to improve vitamin D status in some dogs with CHF may prove beneficial without causing toxicity.

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Section: Discussionsupporting

confidence: 83%

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confidence: 99%

Relation of Vitamin D Status to Congestive Heart Failure and Cardiovascular Events in Dogs

Kraus

Rassnick

Wakshlag

et al. 2013

Veterinary Internal Medicne

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“…BNP is also associated with silent myocardial ischaemia in patients with type 2 diabetes mellitus [30] and an inverse association exists between 25OHD levels and BNP levels in heart failure patients [31] and in patients referred for coronary angiography [32]. Reductions in BNP levels subsequent to vitamin D supplementation could therefore be due to reductions in blood pressure with consequent beneficial effects on left ventricular remodelling; they could also be due to antiischaemic effects on the myocardium.…”

Section: Discussionmentioning

confidence: 99%

The effect of different doses of vitamin D3 on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial

et al. 2010

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Aims/hypothesis Low 25-hydroxyvitamin D levels predict future cardiovascular events and are common in patients with type 2 diabetes. We compared the effect of 100,000 and 200,000 IU doses of vitamin D 3 on endothelial function, blood pressure and markers of glycaemic control in patients with type 2 diabetes. Methods This was a randomised, parallel group, placebocontrolled trial. Patients with type 2 diabetes and baseline 25-hydroxyvitamin D levels <100 nmol/l were enrolled from community and hospital-based diabetes clinics. Participants were assessed in a university department of clinical pharmacology and received a single oral dose of placebo or vitamin D 3 (100,000 IU or 200,000 IU) at baseline, randomly allocated via numbered bottles prepared offsite; participants and investigators were both blinded to treatment allocation. Endothelial function, office blood pressure, B-type natriuretic peptide, insulin resistance and glycosylated haemoglobin were measured at baseline, and at 8 and 16 weeks.

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“…Zittermann et al found significantly reduced 25(OH)D and 1,25(OH)2D levels in 54 heart-failure patients when compared with 34 age-, sex-, and BMI-matched controls [82]. In a study among 102 African Americans, vitamin D deficiency was observed in 84-96% of heart-failure patients, whereas only one-third of the healthy controls was vitamin D deficient [83].…”

Section: Vitamin D Deficiency and Heart Failure In Adultsmentioning

confidence: 96%

Vitamin D deficiency and myocardial diseases

Pilz

Tomaschitz

Drechsler

et al. 2010

Molecular Nutrition Food Res

134

142

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Vitamin D deficiency is common among patients with myocardial diseases because sun-induced vitamin D production in the skin and dietary intake of vitamin D is often insufficient. Knockout mice for the vitamin D receptor develop myocardial hypertrophy and dysfunction. It has also been shown that children with rickets who suffered from severe heart failure could be successfully treated with supplementation of vitamin D plus calcium. In adults, almost all patients with heart failure exhibit reduced 25-hydroxyvitamin D levels, which are used to classify the vitamin D status. In prospective studies, vitamin D deficiency was an independent risk factor for mortality, deaths due to heart failure and sudden cardiac death. Several vitamin D effects on the electrophysiology, contractility, and structure of the heart suggest that vitamin D deficiency might be a causal factor for myocardial diseases. Data from interventional trials, however, are rare and urgently needed to elucidate whether vitamin D supplementation is useful for the treatment of myocardial diseases. In our opinion, the current knowledge of the beneficial effects of vitamin D on myocardial and overall health strongly argue for vitamin D supplementation in all vitamin D-deficient patients with or at high risk for myocardial diseases.

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Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?

Abstract: The low vitamin D status can explain alterations in mineral metabolism as well as myocardial dysfunction in the CHF patients, and it may therefore be a contributing factor in the pathogenesis of CHF.

Cited by 484 publications

References 36 publications

Relation of Vitamin D Status to Congestive Heart Failure and Cardiovascular Events in Dogs

Relation of Vitamin D Status to Congestive Heart Failure and Cardiovascular Events in Dogs

The effect of different doses of vitamin D3 on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial

Vitamin D deficiency and myocardial diseases

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