Role of Vitamin D Deficiency in Coronary Artery Disease and Cardiac Dysfunction
Mohamed Arab
Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamed Abdou *
Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medhat Ibrahim Mahmoud
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Amany Mohyeldin Sediq
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Vitamin D (VD) deficiency may be an important neglected factor in the pathogenesis of cardiovascular disease and its risk factors.
Aim: Investigate the relation between VD level and both exercise parameters and left ventricular systolic and diastolic functions.
Methods: Fasting blood samples were collected from 70 patients with chest pain, and serum levels of vitamin D, glucose, and lipids were measured. They were divided into 2 groups according to VD level. All patients were scheduled for exercise treadmill test and echocardiography.
Results: 30 patients had normal serum VD. They had lower incidence of diabetes, lower levels of total cholesterol and S.LDL. Also, they had longer exercise time (0.37±0.05 vs. 0.31±0.06, P 0.002) with higher metabolic equivalents (METs) (9.52±1.33 vs. 8.49±1.45, P 0.003) and minimal ST-segment depression (0.61±0.11 mm vs. 2.41±1.08 mm, P <0.001). No difference between both groups regarding ejection fraction (P> 0.05) but there was a significant decrease in the E/A ratio of the mitral valve in patients with low VD (1.26±0.27 vs.1.01±0.31, P 0.001). Patients with normal exercise test were 35 patients (50%). They had higher VD level (57.60±9.29 nmol/l vs 34.44±8.11, P <0.001). There was a significant negative correlation between VD and total cholesterol, S.LDL, and the degree of ST-segment depression in exercise ECG. A significant positive correlation was found between VD and both METS and E/A ratio of the mitral valve. Using logistic regression analysis, VD, METs, and diabetes were predictors for both CAD and cardiac dysfunction. Serum VD less than ≤47 nmol/l can predict coronary artery disease (CAD) and cardiac dysfunction with high accuracy (94.4% and 71.4% respectively).
Conclusion: A strong correlation exists between vitamin D and some of CAD risk factors and reduced vitamin D could have a role in exercise parameters abnormalities developed during stress test and diastolic dysfunction seen in patients presented with chest pain.
Keywords: Serum vitamin D, cardiovascular risk factors, coronary artery disease, myocardial dysfunction