Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1731076
Vitamin D Status in Children with Idiopathic Dilated Cardiomyopathy
Funding None.![](https://www.thieme-connect.de/media/10.1055-s-00033103/202101/lookinside/thumbnails/10-1055-s-0041-1731076_2100001-1.jpg)
Abstract
Dilated cardiomyopathy (DCM) is the third leading cause of heart failure in pediatrics. The exact etiology of DCM is unknown in more than half of the cases. Vitamin D receptors are represented in cardiac muscles, endothelium, and smooth muscles of blood vessels suggesting that vitamin D could have a vital cardioprotective function. This study aimed to assess serum level of vitamin D in children with idiopathic DCM and to correlate the serum level of vitamin D with the left ventricular dimensions and function. This study is a descriptive cross-sectional single-center study, includes 44 children of both sexes, diagnosed as idiopathic DCM. Serum level of vitamin D was assessed and correlated with the left ventricular dimensions and function. Mean age of studied children was 6.08 ± 4.4 years. Vitamin D deficiency was found in 90.9% of children with idiopathic DCM with a mean level 13.48 ng/mL. There was a negative correlation between vitamin D level and fraction shortening and left ventricular end-diastolic diameter in children with DCM. Vitamin D level is not only significantly low in children with idiopathic DCM but it is also significantly correlated with the degree of left ventricular dysfunction.
Ethical Approval
The study was approved by the ethics committee of the Faculty of Medicine, Assiut University (IRB no: 17300487). Written informed consents were taken from parents with explanation of benefits of the study; risks expected and suggested treatment for each case.
Authors' Contributions
All authors read and approved the final manuscript. O.E.-A, N.O., and D.R. designed the study, literature search, interpreted the data, and wrote the manuscript. D.R. did echocardiography for all studied cases. M.D. did statistical analysis, share in literature search and writing. A.M. did all laboratory work in addition to interpretation of data.
Publication History
Received: 01 January 2021
Accepted: 07 April 2021
Article published online:
19 June 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Maron BJ, Towbin JA, Thiene G. et al; American Heart Association, Council on Clinical Cardiology, Heart Failure and Transplantation Committee, Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups, Council on Epidemiology and Prevention. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association scientific statement from the council on clinical cardiology, heart failure and transplantation committee; quality of care and outcomes research and functional genomics and translational biology interdisciplinary working groups; and council on epidemiology and prevention. Circulation 2006; 113 (14) 1807-1816
- 2 Richardson P, McKenna W, Bristow M. et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation 1996; 93 (05) 841-842
- 3 Puggia I, Merlo M, Barbati G. et al. Natural history of dilated cardiomyopathy in children. J Am Heart Assoc 2016; 5 (07) e003450
- 4 Cox GF, Sleeper LA, Lowe AM. et al. Factors associated with establishing a causal diagnosis for children with cardiomyopathy. Pediatrics 2006; 118 (04) 1519-1531
- 5 Mor A, Karoli R. Study of vitamin D status in dilated cardiomyopathy at a North India. Age Years 2016; 52 (05) 50-53
- 6 Holick MF. High prevalence of vitamin D inadequacy and implications for health. In Mayo Clinic Proceedings. Elsevier 2006
- 7 Gupta DK, Wang TJ. Looking for a brighter future in heart failure: a role for vitamin D supplementation?. J Am Coll Cardiol 2016; 67 (22) 2604-2606
- 8 Chen S, Law CS, Grigsby CL. et al. Cardiomyocyte-specific deletion of the vitamin D receptor gene results in cardiac hypertrophy. Circulation 2011; 124 (17) 1838-1847
- 9 Babu, P., and F. Damda. “G77 A Case of Dilated Cardiomyopathy Due to Nutritional Vitamin D Deficiency Rickets.”. Archives of Disease in Childhood 98. Suppl 1. 2013; A39-A40 http://dx.doi.org/10.1136/archdischild-2013-304107.089
- 10 Eren E, Abuhandan M, Güzel B, Koca B, Başpınar O. A treatable cause of cardiomyopathy: vitamin D deficiency. Güncel Pediatri 2015; 13 (02) 143-146
- 11 Yilmaz O, Olgun H, Ciftel M. et al. Dilated cardiomyopathy secondary to rickets-related hypocalcaemia: eight case reports and a review of the literature. Cardiol Young 2015; 25 (02) 261-266
- 12 Sanyal D, Raychaudhuri M. Infants with dilated cardiomyopathy and hypocalcemia. Indian J Endocrinol Metab 2013; 17 (Suppl. 01) S221-S223
- 13 Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Körfer R, Stehle P. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?. J Am Coll Cardiol 2003; 41 (01) 105-112
- 14 Priya S, Siddiqi Z, Karoli R, Fatima J, Gupta S, Mishra R. Study of vitamin D status in patients with dilated cardiomyopathy at a teaching hospital in North India. J Cardiovasc Echogr 2016; 26 (03) 89-93
- 15 Liu L, Chen M, Hankins SR. et al; Drexel Cardiovascular Health Collaborative Education, Research, and Evaluation Group. Serum 25-hydroxyvitamin D concentration and mortality from heart failure and cardiovascular disease, and premature mortality from all-cause in United States adults. Am J Cardiol 2012; 110 (06) 834-839
- 16 De Boland AR, Boland RL. Non-genomic signal transduction pathway of vitamin D in muscle. Cell Signal 1994; 6 (07) 717-724
- 17 Souberbielle J-C, Body JJ, Lappe JM. et al. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmun Rev 2010; 9 (11) 709-715
- 18 Schierbeck LL, Jensen TS, Bang U, Jensen G, Køber L, Jensen JE. Parathyroid hormone and vitamin D--markers for cardiovascular and all cause mortality in heart failure. Eur J Heart Fail 2011; 13 (06) 626-632
- 19 Yeşilbaş O, Epçaçan S. Occurrence of nutritional hypocalcaemic rickets-related dilated cardiomyopathy in a child with concomitant rickets and infantile-onset Pompe disease. Cardiol Young 2019; 29 (03) 425-427
- 20 Lang RM, Bierig M, Devereux RB. et al; American Society of Echocardiography's Nomenclature and Standards Committee, Task Force on Chamber Quantification, American College of Cardiology Echocardiography Committee, American Heart Association, European Association of Echocardiography, European Society of Cardiology. Recommendations for chamber quantification. Eur J Echocardiogr 2006; 7 (02) 79-108
- 21 Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357 (03) 266-281
- 22 Holick MF, Binkley NC, Bischoff-Ferrari HA. et al; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96 (07) 1911-1930
- 23 Ross AC, Manson JE, Abrams SA. et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011; 96 (01) 53-58
- 24 Green RJ, Samy G, Miqdady MS. et al. Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days. S Afr Med J 2015; 105 (07) 603-605
- 25 Abu Shady MM, Youssef MM, Salah El-Din EM. et al. Predictors of serum 25-hydroxyvitamin D concentrations among a sample of Egyptian school children. ScientificWorldJournal 2016; 2016: 8175768
- 26 van Ballegooijen AJ, Reinders I, Visser M, Brouwer IA. Parathyroid hormone and cardiovascular disease events: a systematic review and meta-analysis of prospective studies. Am Heart J 2013; 165 (05) 655-664 , 664.e1–664.e5
- 27 Ameri P, Ronco D, Casu M. et al. High prevalence of vitamin D deficiency and its association with left ventricular dilation: an echocardiography study in elderly patients with chronic heart failure. Nutr Metab Cardiovasc Dis 2010; 20 (09) 633-640
- 28 Fuster Siebert M, Novo Rodríguez I, Castro-Gago M, Cabanas Gancedo R. Rachitic cardiomyopathy [in Spanish]. Med Clin (Barc) 1983; 80 (08) 386-387
- 29 Olgun H, Ceviz N, Ozkan B. A case of dilated cardiomyopathy due to nutritional vitamin D deficiency rickets. Turk J Pediatr 2003; 45 (02) 152-154
- 30 Kosecik M, Ertas T. Dilated cardiomyopathy due to nutritional vitamin D deficiency rickets. Pediatr Int 2007; 49 (03) 397-399
- 31 Maiya S, Sullivan I, Allgrove J. et al. Hypocalcaemia and vitamin D deficiency: an important, but preventable, cause of life-threatening infant heart failure. Heart 2008; 94 (05) 581-584
- 32 Brown J, Nunez S, Russell M, Spurney C. Hypocalcemic rickets and dilated cardiomyopathy: case reports and review of literature. Pediatr Cardiol 2009; 30 (06) 818-823
- 33 Jammal Addin MB, Young D, McCarrison S, Hunter L. Dilated cardiomyopathy in a national paediatric population. Eur J Pediatr 2019; 178 (08) 1229-1235
- 34 Avsar A, Dogan A, Tavli T. A rare cause of reversible dilated cardiomyopathy: hypocalcemia. Echocardiography 2004; 21 (07) 609-612
- 35 Witte KK, Byrom R, Gierula J. et al. Effects of vitamin D on cardiac function in patients with chronic HF: the VINDICATE study. J Am Coll Cardiol 2016; 67 (22) 2593-2603