Does Vitamin D Deficiency Effect Heart Rate Variability in Low Cardiovascular Risk Population?

Ahmet Nalbant; Mehmet Bulent Vatan; Perihan VarÄ±m; Ceyhun VarÄ±m; Tezcan Kaya; Ali Tamer

doi:10.3889/oamjms.2017.041

Authors

Ahmet Nalbant Sakarya Education and Research Hospital, Internal Medicine, AdapazarÄ±, Sakarya 54000
Mehmet Bulent Vatan Sakarya Universitesi Tip Fakultesi, Cardiology, Sakarya 54000
Perihan VarÄ±m Sakarya Universitesi Tip Fakultesi, Cardiology, Sakarya 54000
Ceyhun VarÄ±m Sakarya Education and Research Hospital, Internal Medicine, AdapazarÄ±, Sakarya 54000
Tezcan Kaya Sakarya Education and Research Hospital, Internal Medicine, AdapazarÄ±, Sakarya 54000
Ali Tamer Sakarya Education and Research Hospital, Internal Medicine, AdapazarÄ±, Sakarya 54000

DOI:

https://doi.org/10.3889/oamjms.2017.041

Keywords:

Autonomic dysfunction, heart rate variability, sudden cardiac death, vitamin D deficiency

Abstract

AIM: This study aimed to evaluate the cardiac autonomic dysfunction and the cardiac arrhythmia risk using heart rate variability parameters in subjects with vitamin D deficiency and low cardiovascular risk.

MATERIAL AND METHODS: One hundred five consecutive individuals, 54 patients with low vitamin D status and 51 healthy controls were enrolled in this study. The overall cardiac autonomic tone was quantified by using various heart rate variability parameters included mean RR interval, mean Heart Rate, mean of standard deviations of intervals for 24 hours (SDNN), standard deviation of averages of intervals (SDANN), mean of standard deviation of intervals for 5 minutes (SDNNI), root mean square of difference of successive intervals (rMSSD) and the proportion of intervals differing more than 50 ms (pNN50) values. The 12-lead ECG was recorded from each participant, and QT intervals were measured.

RESULTS: Baseline demographic profiles were similar between two groups. The heart rate variability parameters such as mean RR interval, mean HR, SDNN, SDANN, SDNNI, rMSSD and pNN50 (%) values were not significantly different in patients with low vitamin D status compared to control group. The electrocardiography analysis revealed only slight but significant prolongation of corrected QT (QTc) intervals in the control group.

CONCLUSION: HRV variables were not significantly altered in patients with vitamin D deficiency in low cardiovascular risk profile group. Further studies evaluating these findings in other cohorts with high cardiovascular risk are required.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Peterlik M, Cross HS. Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur J Clin Invest. 2005;35:290â€“304. https://doi.org/10.1111/j.1365-2362.2005.01487.x PMid:15860041

Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et. al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117:503â€“11. https://doi.org/10.1161/CIRCULATIONAHA.107.706127 PMid:18180395 PMCid:PMC2726624

Holick M F. Vitamin D deficiency. N Engl J Med. 2007;357:266â€“81. https://doi.org/10.1056/NEJMra070553 PMid:17634462

Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. The prevalence of cardiovascular risk factors and the serum levels of vitamin D in the United States: data from the NHANES III. Arch Intern Med. 2007;167:1159â€“65. https://doi.org/10.1001/archinte.167.11.1159 PMid:17563024

Gaddipati VC, Bailey BA, Kuriacose R, Copeland RJ, Manning T, Peiris AN. The relationship of vitamin D status to cardiovascular risk factors and amputation risk in veterans with peripheral arterial disease. J Am Med Dir Assoc. 2011;12:58â€“61. https://doi.org/10.1016/j.jamda.2010.02.006 PMid:21194661

Xiang W, Kong J, Chen S, Cao LP, Qiao G, Zheng W, et.al. Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin-angiotensin systems. Am J Physiol Endocrinol Metab. 2005; 288:125â€“132. https://doi.org/10.1152/ajpendo.00224.2004 PMid:15367398

Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxy vitamin D is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002; 110:229-38. https://doi.org/10.1172/JCI0215219

Riachy R, Vandewalle B, Moerman E, Belaich S, Lukowiak B, Gmyr V, Muharram G, et al. 1,25- Dihydroxyvitamin D3 protects human pancreatic islets against cytokine-induced apoptosis via down-regulation of the Fas receptor. Apoptosis. 2006;11(2):151â€“9. https://doi.org/10.1007/s10495-006-3558-z PMid:16502254

Mitsuhashi T, Morris Jr RC, Ives HE. 1,25-dihydroxyvitamin D3 modulates growth of vascular smooth muscle cells. J Clin Invest 1991;87:1889â€“95. https://doi.org/10.1172/JCI115213 PMid:1645744 PMCid:PMC296939

Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83:754â€“9. PMid:16600924

Kim HW, Park CW, Shin YS, Kim YS, Shin SJ, Choi EJ, et.al. Calcitriol regresses cardiac hypertrophy and qt dispersion in secondary hyperparathyroidism on hemodialysis. Nephron Clin Pract. 2006;102:21â€“ 9. https://doi.org/10.1159/000088295 PMid:16166802

Tishkoff DX, Nibbelink KA, Holmberg KH, Dandu L, Simpson RU. Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility. Endocrinology. 2008;149:558â€“64. https://doi.org/10.1210/en.2007-0805 PMid:17974622 PMCid:PMC2219302

Deo R, Katz R, Shlipak MG, Sotoodehnia N, Psaty BM, Sarnak MJ, et. al. Vitamin D, parathyroid hormone, and sudden cardiac death: results from the Cardiovascular Health Study. Hypertension. 2011;58(6):1021-8. https://doi.org/10.1161/HYPERTENSIONAHA.111.179135 PMid:22068871 PMCid:PMC3337033

Mann MC, Exner DV, Hemmelgarn BR, Sola DY, Turin TC, Ellis L, et al. Vitamin D levels are associated with cardiac autonomic activity in healty humans. Nutrients. 2013;5:2114-27. https://doi.org/10.3390/nu5062114 PMid:23752493 PMCid:PMC3725496

Drechsler C, Pilz S, Obermayer-Pietsch B, Verduijn M, Tomaschitz A, Krane V, et.al. Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients. Eur Heart J. 2010;31:2253â€“61. https://doi.org/10.1093/eurheartj/ehq246 PMid:20688781 PMCid:PMC2938469

John C A, Thomas BJ, Breithardt G, Cerutti S, Cohen RJ, Coumel P, et al. Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology. Heart rate variability. Eur Heart J. 1996;17:354-81. https://doi.org/10.1093/oxfordjournals.eurheartj.a014868

Tsuji H, Larson MG, Venditti FJ Jr, Manders ES, Evans JC, Feldman CL, et.al. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation. 1996;94(11):2850-5. https://doi.org/10.1161/01.CIR.94.11.2850 PMid:8941112

Kleiger RE, Stein PK, Bigger JT. Heart rate variability: Measurement and clinical utility. Ann Noninvasive Electrocardiol. 2005;10:88â€“101. https://doi.org/10.1111/j.1542-474X.2005.10101.x PMid:15649244

Tak YJ, Lee JG, Kim YJ, Lee SY, Cho BM. 25-hydroxyvitamin D and its relationship with autonomic dysfunction using time- and frequency-domain parameters of heart rate variability in Korean populations: a cross-sectional study. Nutrients. 2014; 6(10): 4373-88. https://doi.org/10.3390/nu6104373 PMid:25325256 PMCid:PMC4210923

Koizumi K,Terui N, Kollai M. Effect of cardiac vagal and sympathetic nerve activity on heart rate in rhythmic fluctuations. J Auton Nerv Syst. 1985;12:251â€“9. https://doi.org/10.1016/0165-1838(85)90065-7

Sasaki K, Maruyama R. Consciously controlled breathing decreases the high-frequency component of heart rate variability by inhibiting cardiac parasympathetic nerve activity. Tohoku J Exp Med. 2014; 233(3): 155-63. https://doi.org/10.1620/tjem.233.155 PMid:24965685

Bodyak N, Ayus JC, Achinger S, Shivalingappa V, Ke Q, Chen YS, et.al. Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in dahl salt- sensitive animals. Proc Natl Acad Sci U S A. 2007;104:16810â€“5. https://doi.org/10.1073/pnas.0611202104 PMid:17942703 PMCid:PMC2040477

Beard CM, Fuster V, Elveback LR. Daily and seasonal variation in sudden cardiac death, Rochester, Minnesota, 1950â€“1975. Mayo Clin Proc. 1982;57:704â€“6. PMid:7132431

Peckova M, Fahrenbruch CE, Cobb LA, Hallstrom AP. Weekly and seasonal variation in the incidence of cardiac arrests. Am Heart J. 1999;137:512â€“5. https://doi.org/10.1016/S0002-8703(99)70507-7

Zittermann A, Schleithoff SS, Koerfer R., Vitamin D and vascular calcification. Curr Opin Lipidol. 2007;18:41â€“6. https://doi.org/10.1097/MOL.0b013e328011c6fc PMid:17218831

Kloner RA, Poole WK, Perritt RL. When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220,000 cases. Circulation 1999;100:1630â€“4. https://doi.org/10.1161/01.CIR.100.15.1630 PMid:10517734

Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67:373â€“8. https://doi.org/10.1210/jcem-67-2-373 PMid:2839537

Corr PB, Yamada KA, Witkowski FX, Fozzard HA, Haber E, Jennings RB, et al. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. The heart and cardiovascular system. New York, NY: Raven Press, 1986:1343.