Table of contents
CLIN APPL THROMB HEMOST January 2014 vol. 20 no. 1 98-103
Mehmet Demir, MD1⇑
Umut Uyan, MD1
Mehmet Melek, MD1
1Department of Cardiology, Bursa Yüksek İhtisas Education and Research Hospital, Bursa, Turkey
Mehmet Demir, Department of Cardiology, Bursa Yüksek İhtisas Education and Research Hospital, Yaseminpark sit 4E D11 Osmangazi, 16100 Bursa, Turkey. Email: drmehmetmd@gmail
Background: Vitamin D deficiency is associated with cardiovascular disease such as coronary artery disease, heart failure, and hypertension. Vitamin D deficiency activates the renin–angiotensin–aldosterone system, which affects the cardiovascular system. For this reason, it could be suggested that there is a relationship between vitamin D deficiency and atrial fibrillation (AF). In our study, we compared 25-hydroxyvitamin D (25-OHD) levels between nonvalvular AF, valvular AF, and control groups in sinus rhythm.
Method: A total of 102 patients with nonvalvular chronic AF without any other cardiovascular disease (mean age 62.51 ± 5.88; group I) and 96 patients with AF, which is associated with mitral valve disease (mean age 61.51 ± 5; group II) were included in our study. Of all, 100 age-matched healthy people with sinus rhythm were accepted as control groups (mean age 61.35 ± 5.44). Routine biochemical parameters, 25-OHD and parathormone levels were performed.
Results: Baseline characteristics of the study groups were comparable. Group I patients had a lower vitamin D level than group II and the control group (6.51 ± 4.89, 9.24 ± 7.39, and 11.18 ± 6.98 ng/mL, P < .001, respectively). In groups I and II, the patients’ left atrium diameter and systolic pulmonary artery pressure are higher than the control group.
Conclusion: As a result, our study revealed a relationship between vitamin D deficiency and nonvalvular AF.
Summary by VitaminDWiki
6.5 ng nonvalvular chronic AF
9.2 ng mitral valve disease AF
11.2 ng controls (Recall that vitamin D levels are very low in the Middle East)
Vitamin D deficiency and atrial fibrillation
International Journal of Cardiology, Volume 184, 1 April 2015, Pages 159–162, doi:10.1016/j.ijcard.2015.02.012
Joseph Thompsona, Rynda Nitiahpapanda, Prashan Bhattia, Antonios Kourliourosb, ,
• Vitamin D mediates oxidative stress, calcium homeostasis and the RAAS.
• Experimental studies suggest a role for vitamin D deficiency in atrial fibrillation.
• There is strong evidence for an association between winter season and AF.
• Observational studies investigating vitamin D status and AF provide equivocal results.
Vitamin D deficiency has been linked with hypertension, coronary artery disease, and stroke, but there is no consensus regarding the possible association between vitamin D deficiency and atrial fibrillation (AF). Vitamin D
- negatively regulates the renin–angiotensin–aldosterone-system (RAAS),
- mediates calcium homeostasis,
- binds to vitamin D receptors on cardiac myocytes, and
- has antioxidant properties that may reduce levels of reactive oxygen species (ROS) in the atria,
which contribute to inflammation and proarrhythmic substrate formation.
As vitamin D status is a readily modifiable risk factor this association has potential clinical implications.
An extensive search of the literature identified six studies that specifically investigated vitamin D status and AF.
Results were equivocal with three studies identifying a positive association between vitamin D deficiency and AF, whilst two studies suggested there may be no association. Additionally, one study indicated that elevated vitamin D levels are associated with AF. Whilst the weight of the evidence suggests that there may be an association between vitamin D deficiency and AF, incomparable study designs and methodological limitations hinder interpretation of the current body of evidence. Further work taking into account considerations raised within this paper is required to better understand the relationship between vitamin D status and AF.
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