Atrial fibrillation - Vitamin D improved 1 of 4 measures – March 2015

Effect of Vitamin D Replacement on Atrial Electromechanical Delay in Subjects With Vitamin D Deficiency

Journal of Cardiovascular Electrophysiology, DOI: 10.1111/jce.12656
UĞUR CANPOLAT M.D.*, ÇAĞRI YAYLA M.D., MEHMET KADRI AKBOĞA M.D., ELIF HANDE ÖZCAN M.D., OSMAN TURAK M.D., FIRAT ÖZCAN M.D., SERKAN TOPALOĞLU M.D. and DURSUN ARAS M.D.
Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
*Address for correspondence: Uğur Canpolat, M.D., Türkiye Yüksek İhtisas Training and Research Hospital, Cardiology Clinic, Sıhhiye, 06100, Ankara, Turkey. Fax: +90 312 306 1134; E-mail: dru_canpolat at yahoo.com

Objectives
Limited data are available regarding cardiac arrhythmias in vitamin D (VitD) deficiency. Therefore, we aimed to assess whether atrial electromechanical delay (AEMD) measured by tissue Doppler imaging (TDI), which is an indicator for atrial fibrillation (AF) development, is prolonged in patients with VitD deficiency as compared to control group. The effect of vitD replacement on AEMD was also evaluated.

Methods
In this prospective study a total of 28 VitD deficient and 56 age-, gender- and BMI-matched VitD sufficient healthy participants were enrolled. P-wave dispersion (PWd) was calculated on the 12-lead electrocardiogram. Both intra- and inter-AEMD were calculated by TDI. Measurements were performed at baseline in both groups and were repeated after 6-month replacement therapy in subjects with vitD deficiency.

Results
PWd, inter- and left intra-AEMD were significantly prolonged in patients with VitD deficiency compared to control group (p < 0.001). While serum 25(OH)D levels were significantly and negatively correlated with left intra-AEMD (r = −0.657, p < 0.001), there was a positive correlation between serum 25(OH)D level and PWd (r = 0.523, p < 0.001). Serum 25(OH)D level was found as the independent predictor of the both left intra- and inter-AEMD in the multivariate linear regression analysis (β:-0.552, p < 0.001 and β:-0.555, p < 0.001, respectively). Serum 25(OH)D level was significantly increased after replacement therapy. While inter-AEMD was significantly decreased (p = 0.013), there was no change in PWD, left and right intra-AEMD (p > 0.05) following replacement therapy.

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Conclusion
PWd, left intra- and inter-AEMD are increased in patients with VitD deficiency.
Serum 25(OH)D level was found as an independent predictor for AEMD in patients with VitD deficiency. Also a significant decrement was observed in inter-AEMD following vitD replacement therapy. Studies with longer follow-up are needed whether vitD deficient patients with prolonged AEMD would develop clinical arrhythmia and vitD replacement would reduce the risk of atrial arrhythmias.