Skip to main content

Advertisement

SpringerLink
Log in

Calcium and Vitamin D Status in Heart Failure Patients in Isfahan, Iran

  • Published:
Biological Trace Element Research Aims and scope Submit manuscript

Abstract

Both calcium and vitamin D play important roles in cardiac muscle contraction and performance. In this cross-sectional study, we evaluated the status of serum calcium, PTH and 25(OH)D3 and their correlation with left ventricular Function and NYHA Functional class in 95 heart failure patients referred to Shahid Chamran Hospital, Isfahan, Iran, by colorimetric, immunoradiometric, and Immunochemiluminescent assays, echocardiography and interview respectively. The study was performed between Oct 2007 and Feb 2008. Twenty eight women and 67 men of functional classes 1, 2, or 3 participated in the study. Mean (SD) of age of the participants was 62(11) years. Mean (SD) serum calcium and 25(OH)D3 were 2.41(0.16) mmol/L and 56.78(51.33) nmol/L, respectively. The overall prevalence of low vitamin D status was 84.2%. There was no correlation between serum calcium and 25(OH)D3 with LVEF. Interestingly, patients with hyperparathyroidism (serum PTH>65 ng/L) had lower LVEF (27% versus 32.5% p = 0.03). NYHA functional class was worse in patients with hyperparathyroidism (p = 0.08). Hypovitaminosis D is very prevalent in heart failure patients. Hyperparathyroidism in these patients may adversely affect cardiac function. Vitamin D3 might serve as an adjunctive treatment for heart failure patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, Witteman JC, Stricker BH (2004) Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J 25:1614–1619

    Article  PubMed  Google Scholar 

  2. Loehr LR, Rosamond WD, Chang PP, Folsom AR, Chambless LE (2008) Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). Am J Cardiol 101:1016–1022

    Article  PubMed  Google Scholar 

  3. Curtis LH, Greiner MA, Hammill BG, Kramer JM, Whellan DJ, Schulman KA, Hernandez AF (2008) Early and long-term outcomes of heart failure in elderly persons, 2001–2005. Arch Intern Med 168:2481–2488

    Article  PubMed  Google Scholar 

  4. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783

    Article  CAS  PubMed  Google Scholar 

  5. Xiang W, Kong J, Chen S, Cao LP, Qiao G, Zheng W, Liu W, Li X, Gardner DG, Li YC (2005) Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin–angiotensin systems. Am J Physiol Endocrinol Metab 288:E125–E132

    Article  CAS  PubMed  Google Scholar 

  6. Li YC, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J (2004) Vitamin D: a negative endocrine regulator of the renin–angiotensin system and blood pressure. J Steroid Biochem Mol Biol 89-90:387–392

    Article  CAS  PubMed  Google Scholar 

  7. Alsafwah S, Laguardia SP, Arroyo M, Dockery BK, Bhattacharya SK, Ahokas RA, Newman KP (2007) Congestive heart failure is a systemic illness: a role for minerals and micronutrients. Clin Med Res 5:238–243

    Article  CAS  PubMed  Google Scholar 

  8. Newman KP, Neal MT, Roberts M, Goodwin KD, Hatcher EA, Bhattacharya SK (2007) The importance of lost minerals in heart failure. Cardiovasc Hematol Agents Med Chem 5:295–299

    Article  CAS  PubMed  Google Scholar 

  9. Laguardia SP, Dockery BK, Bhattacharya SK, Nelson MD, Carbone LD, Weber KT (2006) Secondary hyperparathyroidism and hypovitaminosis D in African–Americans with decompensated heart failure. Am J Med Sci 332:112–118

    Article  PubMed  Google Scholar 

  10. Khouzam RN, Dishmon DA, Farah V, Flax SD, Carbone LD, Weber KT (2006) Secondary hyperparathyroidism in patients with untreated and treated congestive heart failure. Am J Med Sci 331:30–34

    Article  PubMed  Google Scholar 

  11. Nibbelink KA, Tishkoff DX, Hershey SD, Rahman A, Simpson RU (2007) 1,25(OH)2-vitamin D3 actions on cell proliferation, size, gene expression, and receptor localization, in the HL-1 cardiac myocyte. J Steroid Biochem Mol Biol 103:533–537

    Article  CAS  PubMed  Google Scholar 

  12. Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ (2008) Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol 102:1540–1544

    Article  CAS  PubMed  Google Scholar 

  13. The Criteria Committee of the New York Heart Association (1994) Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. Little Brown, Boston

    Google Scholar 

  14. Witte KK, Clark AL (2006) Micronutrients and their supplementation in chronic cardiac failure. An update beyond theoretical perspectives. Heart Fail Rev 11:65–74

    Article  CAS  PubMed  Google Scholar 

  15. Zittermann A, Schleithoff SS, Koerfer R (2006) Vitamin D insufficiency in congestive heart failure: why and what to do about it? Heart Fail Rev 11:25–33

    Article  CAS  PubMed  Google Scholar 

  16. Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Korfer R, Stehle P (2003) Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 41:105–112

    Article  CAS  PubMed  Google Scholar 

  17. Haug CJ, Aukrust P, Haug E, Morkrid L, Muller F, Froland SS (1998) Severe deficiency of 1, 25-dihydroxyvitamin D3 in human immunodeficiency virus infection: association with immunological hyperactivity and only minor changes in calcium homeostasis. J Clin Endocrinol Metab 83:3832–3838

    Article  CAS  PubMed  Google Scholar 

  18. Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R (2006) Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 83:754–759

    CAS  PubMed  Google Scholar 

  19. Zittermann A, Schleithoff SS, Koerfer R (2005) Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 94:483–492

    Article  CAS  PubMed  Google Scholar 

  20. Halapas A, Diamanti-Kandarakis E, Kremastinos D, Koutsilieris M (2006) The PTHrP/PTH.1-R bioregulation system in cardiac hypertrophy: possible therapeutic implications. In Vivo 20:837–844

    CAS  PubMed  Google Scholar 

  21. Dastur DK, Gagrat BM, Wadia NH, Desai M, Bharucha EP (1975) Nature of muscular change in osteomalacia: light- and electron-microscope observations. J Pathol 117:211–228

    Article  CAS  PubMed  Google Scholar 

  22. Selles J, Boland R (1991) Evidence on the participation of the 3', 5'-cyclic AMP pathway in the non-genomic action of 1, 25-dihydroxy-vitamin D3 in cardiac muscle. Mol Cell Endocrinol 82:229–235

    Article  CAS  PubMed  Google Scholar 

  23. Rahman A, Hershey S, Ahmed S, Nibbelink K, Simpson RU (2007) Heart extracellular matrix gene expression profile in the vitamin D receptor knockout mice. J Steroid Biochem Mol Biol 103:416–419

    Article  CAS  PubMed  Google Scholar 

  24. Grayburn PA, Appleton CP, DeMaria AN, Greenberg B, Lowes B, Oh J, Plehn JF, Rahko P, St John SM, Eichhorn EJ (2005) Echocardiographic predictors of morbidity and mortality in patients with advanced heart failure: the Beta-blocker Evaluation of Survival Trial (BEST). J Am Coll Cardiol 45:1064–1071

    Article  PubMed  Google Scholar 

  25. Frost RJ, Sonne C, Wehr U, Stempfle HU (2007) Effects of calcium supplementation on bone loss and fractures in congestive heart failure. Eur J Endocrinol 156:309–314

    Article  CAS  PubMed  Google Scholar 

  26. McGonigle RJ, Fowler MB, Timmis AB, Weston MJ, Parsons V (1984) Uremic cardiomyopathy: potential role of vitamin D and parathyroid hormone. Nephron 36:94–100

    Article  CAS  PubMed  Google Scholar 

  27. McCarty MF (2005) Nutritional modulation of parathyroid hormone secretion may influence risk for left ventricular hypertrophy. Med Hypotheses 64:1015–1021

    Article  CAS  PubMed  Google Scholar 

  28. Rostand SG, Drueke TB (1999) Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failure. Kidney Int 56:383–392

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful both to Dr. Golestanfar and Sattari from Pars medical laboratories for their kind help and the patients who participated in this study.

Author information

Authors and Affiliations

  1. Isfahan University of Medical Sciences, Isfahan Cardiovascular Research Center, Isfahan, Iran

    Mohammad Garakyaraghi

  2. Isfahan University of Medical Sciences, Isfahan, Iran

    Maryam Kerdegari

  3. Isfahan University of Medical Sciences, Isfahan Endocrine & Metabolism Research Center, Sedigheh Tahereh Medical Research Complex, Khorram Street, 8187698191, Isfahan, Iran

    Mansour Siavash

Authors
  1. Mohammad Garakyaraghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maryam Kerdegari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mansour Siavash
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mansour Siavash.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Garakyaraghi, M., Kerdegari, M. & Siavash, M. Calcium and Vitamin D Status in Heart Failure Patients in Isfahan, Iran. Biol Trace Elem Res 135, 67–73 (2010). https://doi.org/10.1007/s12011-009-8492-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12011-009-8492-9

Keywords

Search

Navigation