Araştırma Makalesi
BibTex RIS Kaynak Göster

D vitamini eksikliği yaşlılarda ventriküler repolarizasyonu etkiliyor mu?

Yıl 2024, Cilt: 17 Sayı: 3, 440 - 447, 05.07.2024
https://doi.org/10.31362/patd.1382849

Öz

Amaç: Bu çalışmanın amacı, D vitamini eksikliğinin yaşlı hastalarda anormal ventriküler repolarizasyonun elektrokardiyografik indeksleri ile ilişkili olup olmadığını belirlemektir.
Gereç ve yöntem: 138 hasta üç gruba ayrıldı: D vitamini eksikliği olan hastalar, D vitamini yetersizliği olan hastalar ve yeterli D vitamini düzeyine sahip hastalar. 12 derivasyonlu elektrokardiyografi ve laboratuvar verileri toplandı.
Bulgular: İstirahat kalp hızı, PR aralığı, QRS süresi, QTd ve Tp-e dispersiyonu gruplar arasında benzerdi. Ancak, D vitamini eksikliği olan hastalarda QTc aralığı, D vitamini düzeyi yeterli olan hastalara kıyasla anlamlı derecede uzamıştı. D vitamini düzeyi QTc aralığının tek bağımsız belirleyicisi olarak bulundu. ROC analizinde QTc aralığında anlamlı uzamayı belirleyen D vitamini düzeyinin eşik değeri 20 ng/ml olarak bulundu (Eğri Altındaki Alan: 0,629±0,051 (%95 GA: 0,530-0,728, p=0,013).
Sonuç: Düşük D vitamini düzeyleri yaşlılarda QTc uzaması ile ilişkilidir. D vitamini eksikliği olan yaşlı hastalar rutin EKG taramasından fayda görebilir. D vitamini eksikliğinin zamanında teşhis ve tedavisi, bu hasta popülasyonunda aritmi oranını azaltmaya yardımcı olabilir.

Kaynakça

  • 1. Khanolkar S, Hirani S, Mishra A, et al. Exploring the role of vitamin D in atherosclerosis and its impact on cardiovascular events: a comprehensive review. Cureus 2023;15:e42470. https://doi.org/10.7759/cureus.42470
  • 2. Reddy Vanga S, Good M, Howard PA, Vacek JL. Role of vitamin D in cardiovascular health. Am J Cardiol 2010;106:798-805. https://doi.org/10.1016/j.amjcard.2010.04.042
  • 3. Sánchez Martínez R, Castillo AI, Steinmeyer A, Aranda A. The retinoid X receptor ligand restores defective signalling by the vitamin D receptor. EMBO Rep 2006;7:1030-1034. https://doi.org/10.1038/sj.embor.7400776
  • 4. Muscogiuri G, Annweiler C, Duval G, et al. Vitamin D and cardiovascular disease: from atherosclerosis to myocardial infarction and stroke. Int J Cardiol 2017;230:577-584. https://doi.org/10.1016/j.ijcard.2016.12.053
  • 5. Chowdhury R, Kunutsor S, Vitezova A, et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ 2014;348:g1903. https://doi.org/10.1136/bmj.g1903
  • 6. Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:503-511. https://doi.org/10.1161/CIRCULATIONAHA.107.706127
  • 7. Płudowski P, Kos Kudła B, Walczak M, et al. Guidelines for preventing and treating Vitamin D deficiency: a 2023 update in Poland. Nutrients 2023;15:695. https://doi.org/10.3390/nu15030695
  • 8. Zareba W, Moss AJ, le Cessie S. Dispersion of ventricular repolarization and arrhythmic cardiac death in coronary artery disease. Am J Cardiol 1994;74:550-553. https://doi.org/10.1016/0002-9149(94)90742-0
  • 9. Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J 1998;19:1054-1062. https://doi.org/10.1053/euhj.1997.0865
  • 10. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41:575-580. https://doi.org/10.1016/j.jelectrocard.2008.07.030
  • 11. Barsan M, Brata AM, Ismaiel A, et al. The pathogenesis of cardiac arrhythmias in vitamin D deficiency. Biomedicines 2022;10:1239. https://doi.org/10.3390/biomedicines10061239
  • 12. Bekdas M, Inanir M, Ilhan Z, Ildes E. Effects of serum vitamin D level on ventricular repolarization in children and adolescents. Bratisl Lek Listy 2021;122:816-820. https://doi.org/10.4149/BLL_2021_130
  • 13. Bagrul D, Atik F. Association of vitamin D deficiency with ventricular repolarization abnormalities. Kardiol Pol 2019;77:853-858. https://doi.org/10.33963/KP.14888
  • 14. Nibbelink KA, Tishkoff DX, Hershey SD, Rahman A, Simpson RU. 1,25(OH)2-vitamin D3 actions on cell proliferation, size, gene expression, and receptor localization, in the HL-1 cardiac myocyte. J Steroid Biochem Mol Biol 2007;103:533-537. https://doi.org/10.1016/j.jsbmb.2006.12.099
  • 15. McGreevy C, Williams D. New insights about vitamin D and cardiovascular disease: a narrative review. Ann Intern Med 2011;155:820-826. https://doi.org/10.7326/0003-4819-155-12-201112200-00004
  • 16. Chen WR, Liu ZY, Shi Y, et al. Relation of low vitamin D to nonvalvular persistent atrial fibrillation in Chinese patients. Ann Noninvasive Electrocardiol 2014;19:166-73. https://doi.org/10.1111/anec.12105
  • 17. Kara H, Yasim A. Effects of high-dose vitamin D supplementation on the occurrence of post-operative atrial fibrillation after coronary artery bypass grafting: randomized controlled trial. Gen Thorac Cardiovasc Surg 2020;68:477-484. https://doi.org/10.1007/s11748-019-01209-0
  • 18. Turin A, Bax JJ, Doukas D, et al. Interactions among Vitamin D, atrial fibrillation, and the renin-angiotensin-aldosterone system. Am J Cardiol 2018;122:780-784. https://doi.org/10.1016/j.amjcard.2018.05.013
  • 19. D’Imperio S, Monasky MM, Micaglio E, Negro G, Pappone C. Impact of dietary factors on brugada syndrome and long QT syndrome. Nutrients 2021;13:2482. https://doi.org/10.3390/nu13082482
  • 20. Deo R, Katz R, Shlipak MG, et al. Vitamin D, parathyroid hormone, and sudden cardiac death: results from the Cardiovascular Health Study. Hypertension 2011;58:1021-1028. https://doi.org/10.1161/HYPERTENSIONAHA.111.179135
  • 21. Yetkin DO, Kucukkaya B, Turhan M, Oren M. The effect of 25-hydroxyvitamin D levels on QT interval duration and dispersion in type 2 diabetic patients. Croat Med J 2015;56:525-530. https://doi.org/10.3325/cmj.2015.56.525
  • 22. Locati ET, Bagliani G, Cecchi F, Johny H, Lunati M, Pappone C. Arrhythmias due to inherited and acquired abnormalities of ventricular repolarization. Card Electrophysiol Clin 2019;11:345-362. https://doi.org/10.1016/j.ccep.2019.02.009
  • 23. Galluzzo A, Gallo C, Battaglia A, et al. Prolonged QT interval in ST-elevation myocardial infarction: predictors and prognostic value in medium-term follow-up. J Cardiovasc Med (Hagerstown) 2016;17:440-445. https://doi.org/10.2459/JCM.0000000000000317
  • 24. Perrier E, Kerfant BG, Lalevee N, et al. Mineralocorticoid receptor antagonism prevents the electrical remodeling that precedes cellular hypertrophy after myocardial infarction. Circulation 2004;110:776-783. https://doi.org/10.1161/01.CIR.0000138973.55605.38
  • 25. 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;149:558-564. https://doi.org/10.1210/en.2007-0805
  • 26. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest 2002;110:229-238. https://doi.org/10.1172/JCI15219

Does vitamin D deficiency affect ventricular repolarization in the elderly?

Yıl 2024, Cilt: 17 Sayı: 3, 440 - 447, 05.07.2024
https://doi.org/10.31362/patd.1382849

Öz

Purpose: In this study, we aimed to establish if vitamin D deficiency interacts with the electrocardiographic indices of abnormal ventricular repolarization in elderly patients.
Material and methods: 138 patients were divided into three groups: patients with vitamin D deficiency, patients with vitamin D insufficiency, and patients with adequate vitamin D levels. 12-lead electrocardiography and laboratory data were collected.
Results: The resting heart rate, PR interval, Tp-e interval, QRS duration, Tp-e/QTc, QT dispersion, and Tp-e dispersion were similar among the groups. However, the QTc interval was significantly prolonged in patients with vitamin D deficiency when compared to patients with sufficient vitamin D levels. Vitamin D level was found as the only independent predictor of the QTc interval. The cut-off value of Vitamin D level determining the significant prolongation of QTc interval was found to be 20 ng/ml on ROC analysis (Area Under Curve: 0.629±0.051 (95% CI: 0.530-0.728, p=0.013).
Conclusion: Low vitamin D levels are related to QTc prolongation in the elderly. Vitamin D-deficient elderly patients may benefit from routine ECG screening. Timely diagnosis and treatment of vitamin D deficiency may aid in reducing the rate of arrhythmias in this patient population.

Kaynakça

  • 1. Khanolkar S, Hirani S, Mishra A, et al. Exploring the role of vitamin D in atherosclerosis and its impact on cardiovascular events: a comprehensive review. Cureus 2023;15:e42470. https://doi.org/10.7759/cureus.42470
  • 2. Reddy Vanga S, Good M, Howard PA, Vacek JL. Role of vitamin D in cardiovascular health. Am J Cardiol 2010;106:798-805. https://doi.org/10.1016/j.amjcard.2010.04.042
  • 3. Sánchez Martínez R, Castillo AI, Steinmeyer A, Aranda A. The retinoid X receptor ligand restores defective signalling by the vitamin D receptor. EMBO Rep 2006;7:1030-1034. https://doi.org/10.1038/sj.embor.7400776
  • 4. Muscogiuri G, Annweiler C, Duval G, et al. Vitamin D and cardiovascular disease: from atherosclerosis to myocardial infarction and stroke. Int J Cardiol 2017;230:577-584. https://doi.org/10.1016/j.ijcard.2016.12.053
  • 5. Chowdhury R, Kunutsor S, Vitezova A, et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ 2014;348:g1903. https://doi.org/10.1136/bmj.g1903
  • 6. Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:503-511. https://doi.org/10.1161/CIRCULATIONAHA.107.706127
  • 7. Płudowski P, Kos Kudła B, Walczak M, et al. Guidelines for preventing and treating Vitamin D deficiency: a 2023 update in Poland. Nutrients 2023;15:695. https://doi.org/10.3390/nu15030695
  • 8. Zareba W, Moss AJ, le Cessie S. Dispersion of ventricular repolarization and arrhythmic cardiac death in coronary artery disease. Am J Cardiol 1994;74:550-553. https://doi.org/10.1016/0002-9149(94)90742-0
  • 9. Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J 1998;19:1054-1062. https://doi.org/10.1053/euhj.1997.0865
  • 10. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41:575-580. https://doi.org/10.1016/j.jelectrocard.2008.07.030
  • 11. Barsan M, Brata AM, Ismaiel A, et al. The pathogenesis of cardiac arrhythmias in vitamin D deficiency. Biomedicines 2022;10:1239. https://doi.org/10.3390/biomedicines10061239
  • 12. Bekdas M, Inanir M, Ilhan Z, Ildes E. Effects of serum vitamin D level on ventricular repolarization in children and adolescents. Bratisl Lek Listy 2021;122:816-820. https://doi.org/10.4149/BLL_2021_130
  • 13. Bagrul D, Atik F. Association of vitamin D deficiency with ventricular repolarization abnormalities. Kardiol Pol 2019;77:853-858. https://doi.org/10.33963/KP.14888
  • 14. Nibbelink KA, Tishkoff DX, Hershey SD, Rahman A, Simpson RU. 1,25(OH)2-vitamin D3 actions on cell proliferation, size, gene expression, and receptor localization, in the HL-1 cardiac myocyte. J Steroid Biochem Mol Biol 2007;103:533-537. https://doi.org/10.1016/j.jsbmb.2006.12.099
  • 15. McGreevy C, Williams D. New insights about vitamin D and cardiovascular disease: a narrative review. Ann Intern Med 2011;155:820-826. https://doi.org/10.7326/0003-4819-155-12-201112200-00004
  • 16. Chen WR, Liu ZY, Shi Y, et al. Relation of low vitamin D to nonvalvular persistent atrial fibrillation in Chinese patients. Ann Noninvasive Electrocardiol 2014;19:166-73. https://doi.org/10.1111/anec.12105
  • 17. Kara H, Yasim A. Effects of high-dose vitamin D supplementation on the occurrence of post-operative atrial fibrillation after coronary artery bypass grafting: randomized controlled trial. Gen Thorac Cardiovasc Surg 2020;68:477-484. https://doi.org/10.1007/s11748-019-01209-0
  • 18. Turin A, Bax JJ, Doukas D, et al. Interactions among Vitamin D, atrial fibrillation, and the renin-angiotensin-aldosterone system. Am J Cardiol 2018;122:780-784. https://doi.org/10.1016/j.amjcard.2018.05.013
  • 19. D’Imperio S, Monasky MM, Micaglio E, Negro G, Pappone C. Impact of dietary factors on brugada syndrome and long QT syndrome. Nutrients 2021;13:2482. https://doi.org/10.3390/nu13082482
  • 20. Deo R, Katz R, Shlipak MG, et al. Vitamin D, parathyroid hormone, and sudden cardiac death: results from the Cardiovascular Health Study. Hypertension 2011;58:1021-1028. https://doi.org/10.1161/HYPERTENSIONAHA.111.179135
  • 21. Yetkin DO, Kucukkaya B, Turhan M, Oren M. The effect of 25-hydroxyvitamin D levels on QT interval duration and dispersion in type 2 diabetic patients. Croat Med J 2015;56:525-530. https://doi.org/10.3325/cmj.2015.56.525
  • 22. Locati ET, Bagliani G, Cecchi F, Johny H, Lunati M, Pappone C. Arrhythmias due to inherited and acquired abnormalities of ventricular repolarization. Card Electrophysiol Clin 2019;11:345-362. https://doi.org/10.1016/j.ccep.2019.02.009
  • 23. Galluzzo A, Gallo C, Battaglia A, et al. Prolonged QT interval in ST-elevation myocardial infarction: predictors and prognostic value in medium-term follow-up. J Cardiovasc Med (Hagerstown) 2016;17:440-445. https://doi.org/10.2459/JCM.0000000000000317
  • 24. Perrier E, Kerfant BG, Lalevee N, et al. Mineralocorticoid receptor antagonism prevents the electrical remodeling that precedes cellular hypertrophy after myocardial infarction. Circulation 2004;110:776-783. https://doi.org/10.1161/01.CIR.0000138973.55605.38
  • 25. 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;149:558-564. https://doi.org/10.1210/en.2007-0805
  • 26. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest 2002;110:229-238. https://doi.org/10.1172/JCI15219
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyovasküler Tıp ve Hematoloji (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

İrem Müge Akbulut 0000-0002-9190-0009

Büşra Yurumez 0000-0002-6426-6583

Volkan Atmış 0000-0002-0080-6448

Murat Varlı 0000-0003-1176-5255

Erken Görünüm Tarihi 22 Mart 2024
Yayımlanma Tarihi 5 Temmuz 2024
Gönderilme Tarihi 29 Ekim 2023
Kabul Tarihi 22 Mart 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 17 Sayı: 3

Kaynak Göster

APA Akbulut, İ. M., Yurumez, B., Atmış, V., Varlı, M. (2024). Does vitamin D deficiency affect ventricular repolarization in the elderly?. Pamukkale Medical Journal, 17(3), 440-447. https://doi.org/10.31362/patd.1382849
AMA Akbulut İM, Yurumez B, Atmış V, Varlı M. Does vitamin D deficiency affect ventricular repolarization in the elderly?. Pam Tıp Derg. Temmuz 2024;17(3):440-447. doi:10.31362/patd.1382849
Chicago Akbulut, İrem Müge, Büşra Yurumez, Volkan Atmış, ve Murat Varlı. “Does Vitamin D Deficiency Affect Ventricular Repolarization in the Elderly?”. Pamukkale Medical Journal 17, sy. 3 (Temmuz 2024): 440-47. https://doi.org/10.31362/patd.1382849.
EndNote Akbulut İM, Yurumez B, Atmış V, Varlı M (01 Temmuz 2024) Does vitamin D deficiency affect ventricular repolarization in the elderly?. Pamukkale Medical Journal 17 3 440–447.
IEEE İ. M. Akbulut, B. Yurumez, V. Atmış, ve M. Varlı, “Does vitamin D deficiency affect ventricular repolarization in the elderly?”, Pam Tıp Derg, c. 17, sy. 3, ss. 440–447, 2024, doi: 10.31362/patd.1382849.
ISNAD Akbulut, İrem Müge vd. “Does Vitamin D Deficiency Affect Ventricular Repolarization in the Elderly?”. Pamukkale Medical Journal 17/3 (Temmuz 2024), 440-447. https://doi.org/10.31362/patd.1382849.
JAMA Akbulut İM, Yurumez B, Atmış V, Varlı M. Does vitamin D deficiency affect ventricular repolarization in the elderly?. Pam Tıp Derg. 2024;17:440–447.
MLA Akbulut, İrem Müge vd. “Does Vitamin D Deficiency Affect Ventricular Repolarization in the Elderly?”. Pamukkale Medical Journal, c. 17, sy. 3, 2024, ss. 440-7, doi:10.31362/patd.1382849.
Vancouver Akbulut İM, Yurumez B, Atmış V, Varlı M. Does vitamin D deficiency affect ventricular repolarization in the elderly?. Pam Tıp Derg. 2024;17(3):440-7.
Creative Commons Lisansı
Pamukkale Tıp Dergisi, Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı ile lisanslanmıştır