Role of Vitamin D Deficiency in Coronary Artery Disease and Cardiac Dysfunction

Abstract

Introduction: Vitamin D (VD) deficiency may be an important neglected factor in the pathogenesis of cardiovascular disease and its risk factors. Aim: Investigate the relation between VD level and both exercise parameters and left ventricular systolic and diastolic functions. Methods: Fasting blood samples were collected from 70 patients with chest pain, and serum levels of vitamin D, glucose, and lipids were measured. They were divided into 2 groups according to VD level. All patients were scheduled for exercise treadmill test and echocardiography. Results: 30 patients had normal serum VD. They had lower incidence of diabetes, lower levels of total cholesterol and S.LDL. Also, they had longer exercise time (0.37±0.05 vs. 0.31±0.06, P 0.002) with higher metabolic equivalents (METs) (9.52±1.33 vs. 8.49±1.45, P 0.003) and minimal ST-segment depression (0.61±0.11 mm vs. 2.41±1.08 mm, P <0.001). No difference between both groups regarding ejection fraction (P> 0.05) but there was a significant decrease in the E/A ratio of the mitral valve in patients with low VD (1.26±0.27 vs.1.01±0.31, P 0.001). Patients with normal exercise test were 35 patients (50%). They had higher VD level (57.60±9.29 nmol/l vs 34.44±8.11, P <0.001). There was a significant negative correlation between VD and total cholesterol, S.LDL, and the degree of ST-segment depression in exercise ECG. A significant positive correlation was found between VD and both METS and E/A ratio of the mitral valve. Using logistic regression analysis, VD, METs, and diabetes were predictors for both CAD and cardiac dysfunction. Serum VD less than ≤47 nmol/l can predict coronary artery disease (CAD) and cardiac dysfunction with high accuracy (94.4% and 71.4% respectively). Conclusion: A strong correlation exists between vitamin D and some of CAD risk factors and reduced vitamin D could have a role in exercise parameters abnormalities developed during stress test and diastolic dysfunction seen in patients presented with chest pain.