title: Prevalence and consequences of vitamin D insufficiency in women with takotsubo cardiomyopathy.
abstract: OBJECTIVE
  The purpose of this study was to identify the prevalence and clinical consequences of vitamin D insufficiency in patients with takotsubo cardiomyopathy.
  
  
  BACKGROUND
  Takotsubo cardiomyopathy is a syndrome of acute, transient left ventricular dysfunction seen predominantly in postmenopausal women after acute emotional or physical stress. Postmenopausal women have a high prevalence of bone and musculoskeletal consequences related to hypovitaminosis D. Although rickets is known to cause a reversible dilated cardiomyopathy in children, the importance of vitamin D for adult cardiovascular health is less understood.
  
  
  METHODS
  We prospectively identified patients diagnosed with takotsubo cardiomyopathy at Danbury Hospital from April 2009 through January 2011, collected demographic, clinical, laboratory, and angiographic data, and performed serum 25 hydroxyvitamin D levels during the index hospitalization. Vitamin D insufficiency was defined as serum 25-hydroxy-vitamin D less than 30 ng/mL. We compared parameters of myocardial damage and heart failure between patients with and without vitamin D insufficiency. A χ² test and a Student's t test were used for categorical and continuous variables, respectively. Statistical significance was set at P < .05 (2 tailed).
  
  
  RESULTS
  Twenty-seven women were diagnosed with takotsubo cardiomyopathy during the study period. The mean age was 67.4 years (SD 10.4). The serum 25-hydroxyvitamin D levels were performed on 25 patients, and 17 of these had hypovitaminosis D (68%). A comparison of laboratory and imaging parameters between the 2 groups revealed that patients with hypovitaminosis D had a slightly higher mean left ventricular end-diastolic pressure and lower mean left ventricular ejection fraction (P < .05), suggestive of slightly worse heart failure.
  
  
  CONCLUSIONS
  Women diagnosed with takotsubo cardiomyopathy have a high prevalence of vitamin D insufficiency. In our prospective study of 25 women with takotsubo cardiomyopathy, this was associated with worse hemodynamic parameters.
authors.affiliation: Department of Cardiology, Jacobi Medical Center, 1400 Pelham Parkway South, Building 1, 5 West, Bronx, New York 10461, USA. amitdande@gmail.com
authors.forename: Amit S
authors.initials: AS
authors.lastname: Dande
authors.forename: Salvador F
authors.initials: SF
authors.lastname: Sena
authors.forename: Hal S
authors.initials: HS
authors.lastname: Wasserman
authors.forename: Mark K
authors.initials: MK
authors.lastname: Warshofsky
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Belsky
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000368:Aged; D002112:Calcifediol / Q000097:blood; D015331:Cohort Studies; D003237:Connecticut / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D006321:Heart / Q000503:physiopathology; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006786:Hospitals, Urban; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*
chemical_list: D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol