Sudden drop of heart rate (vasovagal syncope) is associated with lower vitamin D - several studies

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The lifetime incidence of an episode of vasovagal syncope is more than 33%

2023 book - free txt

Note: Founder of VitaminDwiki had one incidence of VVS while on Pritikin Diet

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Vasovagal syncope: An overview of pathophysiological mechanisms - June 2023 ($28 PDF)

https://doi.org/10.1016/j.ejim.2023.03.025
86 references are free online

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Vasovagal Syncope 5.4 X more likely if low vitamin D - meta-analysis May 2023

Association between vitamin D deficiency and vasovagal syncope: A systematic review and meta-analysis
Clin Cardiol . 2023 May 24. doi: 10.1002/clc.24035
Amirmohammad Khalaji 1 2 3, Amir Hossein Behnoush 1 2 3, Masih Tajdini 1

Vasovagal syncope (VVS) is the most prevalent type of syncope and its management includes pharmacologic and non-pharmacologic interventions. Recently, studies have investigated vitamin D levels in VVS patients. In this systematic review and meta-analysis, we aim to review these studies to find possible associations between vitamin D deficiency and vitamin D levels with VVS. International databases including Scopus, Web of Science, PubMed, and Embase were searched with keywords related to "vasovagal syncope" and "vitamin D." Studies were screened and the data were extracted from them. Random-effect meta-analysis was conducted to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for vitamin D levels in comparison to VVS patients and controls. Also, VVS occurrence was measured and the odds ratio (OR) and 95% CI were calculated for comparison of vitamin D deficient cases and nondeficient individuals. Six studies were included with 954 cases investigated. Meta-analysis showed that patients with VVS had significantly lower vitamin D serum levels in comparison to non-VVS cases (SMD -1.05, 95% CI -1.54 to -0.57, p-value < .01).
Moreover, VVS occurrence was higher in vitamin D-deficient individuals (OR 5.43, 95% CI 2.40 to 12.27, p-value < .01). Our findings which show lower vitamin D levels in VVS patients can have clinical implications in order for clinicians to pay attention to this when approaching VVS. Further randomized controlled trials are certainly warranted to assess the role of vitamin D supplementation in individuals with VVS.
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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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Is there any link between vitamin D deficiency and vasovagal syncope? - Feb 2020

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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