The association between vitamin D and myocardial structure and function in congestive heart failure

Objective. Chronic heart failure (CHF) is the most common complication of cardiovascular system diseases associated with unfavorable prognosis. Vitamin D deficiency is an additional factor contributing to the development of cardiovascular pathology. Current evidence on the relationship between vitamin D and the state of the myocardium in patients with CHF is insufficient. The aim of the study was to assess the plasma level of vitamin D in CHF patients and to evaluate its impact on the morphological and functional state of the myocardium.

Design and methods. The study involved 124 patients with CHF I–II functional class and 16 control subjects without CHF. In all patients, vitamin D level was assessed (25(ОН)D total by ELISA) and echocardiography on the apparatus Logiq Р5 (USA) was performed.

Results. The average plasma level of 25 (OH)D in CHF patients was 16,6 (10,9; 23,7) ng/mL that was significantly lower (p = 0,01) than in the control group 42,1 (27,8; 49,6) ng/mL. All patients with CHF were divided by the plasma level of 25 (OH)D according to centile distribution into group I (LQ0–UQ25) with level of 25 (OH)D 10,9 ng/ml, group II (LQ25–UQ75) with level 25 (OH)D 10,9–23,7 ng/ml, and group III (LQ75–UQ100) with level of 25 (OH)D 23,7 ng/ml and above. Systolic blood pressure (SBP) was significantly higher in group I than in group III (p = 0,04), and in the control group this value was significantly lower than in all groups of CHF patients (p < 0,05). Dimensions of the aorta and its sections, left atrium, parameters of end-systolic volume, end-diastolic volume (EDV), thickness of the anterior and posterior left ventricle wall during systole were significantly higher in group I as compared to group II, III and the control group. There is a negative correlation between the plasma level of 25 (OH)D and EDV (R = –0,24; p = 0,03), systolic output (R = –0,28; p = 0,01), dimensions of the aorta at aortal valve (AV) (R = –0,39; p = 0,0002), ascending aorta (R = –0,31; p = 0,02) and aortic arch (R = –0,41; p = 0,002), parameters of anterior (R = –0,36; p = 0,004) and posterior left ventricular wall thickness during systole (R = –0,27; p = 0,01) in all patients with CHF. Also, there is a positive correlation between SBP and aorta dimensions at the AV level (R = 0,44; р = 0,00003) and ascending aorta (R = 0,36; р = 0,006).

Conclusions. Found association of vitamin D plasma levels with structural and functional state of the myocardium indicates the negative impact of vitamin D deficiency on myocardial contractile function, dimensions of the aorta and anterior and posterior walls of the left ventricle.

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