title: Serum 25-hydroxyvitamin D is associated with major cardiovascular risk factors and cardiac structure and function in patients with coronary artery disease.
abstract: OBJECTIVE
  Vitamin D deficiency has been associated with increased risk for cardiovascular (CV) disease, but the possible effects of Vitamin D on cardiac structure and function are not well characterized.
  
  
  RESULTS
  The correlation between 25-hydroxyvitamin D levels and metabolic and cardiac echocardiographic parameters was studied in ARTEMIS study population including 831diabetic and 659 non-diabetic patients with stable coronary artery disease (CAD). Low levels of Vitamin D were associated with high BMI (p < 0.001), high total and LDL cholesterol and triglyceride levels (p < 0.001 for all) in both diabetics and non-diabetics. Among non-diabetic patients, low Vitamin D was also associated independently with elevated systolic and diastolic blood pressure (p < 0.005). Low Vitamin D levels were independently associated with reduced left ventricular (LV) ejection fraction (p < 0.005) and increased left atrial diameter (p < 0.03) measured by cardiac ultrasound by 2-dimensional echo. In the non-diabetic group, low Vitamin D levels were associated with impaired LV filling (high E/E') (p < 0.03) and low E/A mitral flow pattern measured by Doppler echocardiography (p < 0.05). Among diabetics, low Vitamin D levels were also related to increased LV end-systolic diameter (p < 0.05) and right ventricular diameter (p < 0.005). The association between LV diastolic filling (E/E') and Vitamin D levels was significant (p < 0.01) after adjustment for the commonly recognized risk factors of diastolic dysfunction in linear regression analysis.
  
  
  CONCLUSIONS
  Low Vitamin D is associated with several major cardiovascular risk factors and cardiac structural changes including impaired systolic and diastolic function, which together may explain the association of low Vitamin D to worse cardiovascular outcome.
authors: Institute of Clinical Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Finland.
authors: M P
authors: MP
authors: Pekkanen
authors: Institute of Clinical Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Finland. Electronic address: olavi.ukkola@oulu.fi.
authors: O
authors: O
authors: Ukkola
authors: NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry University of Oulu, Oulu, Finland.
authors: P
authors: P
authors: Hedberg
authors: Institute of Clinical Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Finland.
authors: O P
authors: OP
authors: Piira
authors: Institute of Clinical Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Finland.
authors: S
authors: S
authors: Lepojärvi
authors: Institute of Clinical Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Finland.
authors: J
authors: J
authors: Lumme
authors: Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland; Department of Applied Sciences, London South Bank University, London, UK.
authors: M P
authors: MP
authors: Tulppo
authors: Institute of Clinical Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Finland.
authors: H V
authors: HV
authors: Huikuri
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002112:Calcifediol / Q000097:blood*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D005387:Finland / Q000453:epidemiology; D006321:Heart / Q000503:physiopathology*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009929:Organ Size; D015995:Prevalence; D012307:Risk Factors; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014808:Vitamin D Deficiency / Q000097:blood / Q000473:pathology / Q000503:physiopathology*
chemical_list: D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol
keywords: Cardiac ultrasound; Diastolic dysfunction; Risk factors; Vitamin D