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Sudden drop of heart rate is associated with lower vitamin D


Vitamin D Deficiency and Vasovagal Syncope in Children and Adolescents - Feb 2021

Front. Pediatr., 25 February 2021 | https://doi.org/10.3389/fped.2021.575923
Qingyou Zhang, Yan Sun, Chunyu Zhang, Jianguang Qi and Junbao Du*
Department of Pediatrics, Peking University First Hospital, Beijing, China

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Aims: To investigate the association of vitamin D deficiency with cardiovascular autonomic nervous system function in children and adolescents with vasovagal syncope (VVS).

Methods: This study recruited 76 pediatric patients with VVS and 15 healthy children. The 25-hydroxyvitamin D levels in serum among the participants were evaluated. Heart rate variability analysis including SDNN, rMSSD, and SDANN was tested in patients with VVS. The correlation between indices of time-domain analysis and serum vitamin D status of the children with VVS was investigated.

Results: In this work, 25-hydroxyvitamin D levels in serum among VVS cases remarkably decreased compared with those among healthy controls (48.76 ± 19.25 vs. 67.62 ± 15.46 nmol/L, p < 0.01). The vitamin D deficient patients with VVS exhibited a lower rMSDD value compared to the non-deficient group with VVS (45.56 ± 16.87 vs. 61.90 ± 20.38 ms, p < 0.001, respectively). Pearson correlation analysis indicated that serum 25-hydroxyvitamin D levels had positive correlation with rMSDD values (r = 0.466, p < 0.001).

Conclusions: As suggested by our data, VVS children and adolescents with vitamin D deficiency may have cardiac autonomic dysfunction and cardiac vagal tone decreases with the reduction in vitamin D level.

References
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Journal of Arrhythmia 36(2) DOI: 10.1002/joa3.12309
Songül Usalp MD Hatice Kemal MD Ümit Yüksek MD Belma Yaman MD Aziz Günsel MD Oğuzhan Edebal MD Onur Akpınar MD Levent Cerit MD Hamza Duygu MD
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Background
This study aimed to investigate serum 25OHD levels between patients with vasovagal syncope (VVS) diagnosed with head‐up tilt table test (HUTT) and age‐matched healthy people.

Methods
The study included 75 consecutive patients (32.3 ± 10.7 years), who presented with syncope and underwent HUTT and 52 healthy controls (32.9 ± 14.1 years). HUTT patients were divided into two groups according to whether there was syncope response to the test. Patients underwent cardiac, psychiatric, and neurological investigation. Serum 25OHD levels were measured by chemiluminescent microparticle immunoassay method.

Results
There was no difference between the two groups in terms of age, gender, body mass index (BMI), echocardiographic findings (P > .05). Mean serum 25OHD (24.5 ± 6.3 vs 20.1 ± 8.8 ng/mL, P = .003) and vitamin B12 levels (436.4 ± 199.2 vs 363.1 ± 107.6 pg/mL, P = .009) was lower in syncope patients when compared to the control group. In correlation analyses, syncope was shown as correlated with the vitamin D (r = −264, P = .003) and vitamin B12 levels (r = −233, P = .009). But, multivariate regression analyses showed that only vitamin D increased risk of syncope [OR: 0.946, 95% CI (0.901‐0.994)]. There was no difference in terms of age, gender, BMI, echocardiographic findings between the in HUTT positive (n = 45) and negative groups (n = 29). Only vitamin D level was significantly lower in HUTT positive group (17.5 ± 7.7 vs 24.4 ± 9.1 ng/mL, P = .002). There was no difference among in the vasovagal subgroups in terms of vitamin D level and other features.

Conclusion
Vitamin D and B12 levels were reasonably low in syncope patients, but especially low Vitamin D levels were associated with VVS diagnosed in HUTT.



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