Abstract
Vitamin D deficiency is associated with impaired myocardial deformation parameters and cardiovascular disease (CVD). Increased epicardial fat thickness (EFT) is also associated with increased risk of CVD. The aim of the study is to evaluate the effect of vitamin D deficiency and supplementation on myocardial deformation parameters and EFT. The study population consisted of 50 patients with vitamin D deficiency who were free of cardiovascular risk (mean age: 42.6 ± 8.9 years, 37 female). Patients were treated with oral administration of vitamin D3. Myocardial deformation parameters and EFT were evaluated before and after treatment of those patients. Vitamin D levels significantly increased after treatment (30.5 ± 10.5 vs. 9.9 ± 5.3 nmol/l, p < 0.001). There was no significant difference between conventional echocardiographic parameters before and after treatment. Baseline EFT was significantly higher than post-treatment measurements (35.2 ± 8.0 vs. 27.5 ± 5.6 mm, p < 0.001). Post-treatment myocardial deformation parameters were also significantly higher than baseline measurements. Baseline vitamin D levels correlated with baseline EFT and left ventricular global longitudinal strain (LV-GLS). Post-treatment vitamin D levels also correlated with post-treatment EFT, body mass index, and LV-GLS. Baseline vitamin D level was an independent predictor of baseline LV-GLS (p = 0.002). Patients with impaired LV-GLS had significantly lower vitamin D levels than patients with normal LV-GLS (6.6 ± 3.8 vs. 11.0 ± 5.3 nmol/l, p = 0.005). Baseline vitamin D level was also an independent predictor of baseline impaired LV-GLS (p = 0.010). Vitamin D supplementation has beneficial effects on myocardial deformation parameters and EFT. Moreover, baseline vitamin D levels are a predictor of impaired LV-GLS.
Similar content being viewed by others
References
Bouillon R, Carmeliet G, Verlinden L et al (2008) Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 29:726–776
Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281
Pittas AG, Lau J, Hu FB, Dawson-Hughes B (2007) The role of vitamin D and calcium in type 2 diabetes. A systematic review and metaanalysis. J Clin Endocrinol Metab 92(6):2017–2029
Hewison M (2011) Vitamin D and immune function: an overview. Proc Nutr Soc 1:1–12
Michos ED, Melamed ML (2008) Vitamin D and cardiovascular disease risk. Curr Opin Clin Nutr Metab Care 11(1):7–12
Wang TJ, Pencina MJ, Booth SL et al (2008) Vitamin D deficiency and risk of cardiovascular disease. Circulation 117:503–511
Anderson JL, May HT, Horne BD et al (2010) Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol 106:963–968
Grant WB, Cross HS, Garland CF et al (2009) Estimated benefit of increased vitamin D status in reducing the economic burden of disease in western Europe. Prog Biophys Mol Biol 99:104–113
Robinson JG, Gidding SS (2014) Curing atherosclerosis should be the next major cardiovascular prevention goal. J Am Coll Cardiol 63(25 Pt A):2779–2785
Katsiki N, Mikhailidis DP, Wierzbicki AS (2013) Epicardial fat and vascular risk: a narrative review. Curr Opin Cardiol 28(4):458–463
Natale F, Tedesco MA, Mocerino R et al (2009) Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr 10:549–555
Leitman M, Lysyansky P, Sidenko S et al (2004) Two-dimensional strain—a novel software for real-time quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr 17:1021–1029
Chen Y, Zhao CT, Zhen Z, Wong A, Tse HF, Yiu KH (2014) Association of myocardial dysfunction with vitamin D deficiency in patients with type 2 diabetes mellitus. J Diabetes Complicat 28(3):286–290
Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930
Cheitlin MD, Armstrong WF, Aurigemma GP et al (2003) ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J Am Soc Echocardiogr 16:1091–1110
Delgado V, Ypenburg C, van Bommel RJ et al (2008) Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J Am Coll Cardiol 51:1944–1952
Donal E, Tournoux F, Leclercq C et al (2008) Assessment of longitudinal and radial ventricular dyssynchrony in ischemic and nonischemic chronic systolic heart failure: a two-dimensional echocardiographic speckle-tracking strain study. J Am Soc Echocardiogr 21:58–65
Tadic M, Cuspidi C, Pencic B et al (2014) Circadian blood pressure pattern and right ventricular and right atrial mechanics: a two- and three-dimensional echocardiographic study. J Am Soc Hypertens 8(1):45–53
Iacobellis G, Willens HJ (2009) Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 22(12):1311–1319
Marwick TH, Leano RL, Brown J et al (2009) Myocardial strain measurement with 2-dimensional speckle-tracking echocardiography: definition of normal range. JACC Cardiovasc Imaging 2(1):80–84
Xiang W, Kong J, Chen S et al (2005) Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin-angiotensin systems. Am J Physiol Endocrinol Metab 288:E125–E132
Wang TJ, Pencina MJ, Booth SL et al (2008) Vitamin D deficiency and risk of cardiovascular disease. Circulation 117(4):503–511
Spethmann S, Dreger H, Schattke S et al (2012) Two-dimensional speckle tracking of the left ventricle in patients with systemic sclerosis for an early detection of myocardial involvement. Eur Heart J Cardiovasc Imaging 13(10):863–870
Erdoğan E, Akkaya M, Bacaksız A et al (2013) Subclinical left ventricular dysfunction in women with polycystic ovary syndrome: an observational study. Anadolu Kardiyol Derg 13(8):784–790
Cincin A, Sunbul M, Kivrak T et al (2014) Evaluation of cardiac function by two-dimensional speckle tracking echocardiography in ulcerative colitis patients. Dig Dis Sci. doi:10.1007/s10620-014-3274-4
Sunbul M, Durmus E, Kivrak T et al (2013) Left ventricular strain and strain rate by two-dimensional speckle tracking echocardiography in patients with subclinical hypothyroidism. Eur Rev Med Pharmacol Sci 17(24):3323–3328
Tanboğa IH, Işık T, Kaya A, Kurt M (2012) Two-dimensional strain imaging to predict the localization of an accessory pathway. Turk Kardiyol Dern Ars 40(1):108
López-Jiménez F, Sochor O (2014) Epicardial fat, metabolic dysregulation, and cardiovascular risk: putting things together. Rev Esp Cardiol (Engl Ed) 67(6):425–427
Guzzardi MA, Iozzo P (2011) Fatty heart, cardiac damage, and inflammation. Rev Diabet Stud 8:403–417
Iacobellis G, Ribaudo MC, Assael F et al (2003) Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 88:5163–5168
Gupta GK, Agrawal T, DelCore MG, Mohiuddin SM, Agrawal DK (2012) Vitamin D deficiency induces cardiac hypertrophy and inflammation in epicardial adipose tissue in hypercholesterolemic swine. Exp Mol Pathol 93(1):82–90
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sunbul, M., Bozbay, M., Mammadov, C. et al. Effect of vitamin D deficiency and supplementation on myocardial deformation parameters and epicardial fat thickness in patients free of cardiovascular risk. Int J Cardiovasc Imaging 31, 765–772 (2015). https://doi.org/10.1007/s10554-015-0622-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10554-015-0622-1