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Vitamin D deficiency is common and may contribute to cardiovascular diseases. We hypothesized that serum vitamin D (25OHD) levels would be inversely associated with inflammation and with diastolic dysfunction. We therefore investigated the link between serum vitamin D levels (i) echocardiographic measures and (ii) inflammatory parameters.
The cross-sectional study included 281 patients who were referred to coronary angiography for stable angina pectoris. Patients were recruited between December 2010 and November 2011. Patients with established congestive heart failure, gout, chronic kidney disease (estimated glomeruler filtration rate <60 ml/min/1.73 m2), acute infection were not included. We measured serum 25OHD levels, C-reactive protein (CRP) and fibrinogen levels. A radioimmunoassay procedure was used to measure 25OHD (DiaSorin, Stillwater, MN). We also performed standardized left ventricular (LV) echocardiograms and echocardiographic data were used for classification of systolic and diastolic dysfunction. We analyzed the relation between serum levels of 25OHD and inflammatory markers and echocardiographic measures of left ventricular mass and diastolic dysfunction.
At baseline, subjects had a mean age of 59.5±10 years and 43.4% were women. Left ventricular mass index, left atrial diamater, isovolumic relaxation time, E/E’ ratio were significantly higher in patients with lower 25OHD levels. In ordinal logistic regression analysis higher 25OHD was negatively associated only with left ventricular mass index, OR=0.965 (0.939-0.992) p=0.015, isovolumic relaxation time, OR=0.962 (0.939-0,985) p=0.001, E/E’ ratio, OR=0.874 (0.811-0.942) p=0.008 and CRP, OR=0.802 (0.668-0.962) p=0.021.
Serum levels of 25OHD are significantly associated with LV diastolic dysfunction and left ventricular mass index although the effect size is rather small. Longitudinal studies in larger populations are needed to establish firmly or refute a causal relationship between vitamin D levels and diastolic dysfunction and left ventricular mass index.