Advertisement

Submit Manuscripts
Author Information
Subscribe/Renew
Order Reprints
Email Alerts
Feedback
RSS Feed
CME

About the Journal
Editorial Board & Staff

About JACC CME
Hardware/Software Requirements
Contact Us
Policy on Privacy and Confidentiality
Copyright Information

JACC Imaging Homepage JACC Interventions Homepage
Still not a subscriber to JACC Imaging or JACC Interventions?
Click here
to sign up now!

ACC.org
Cardiosmart
Cardiosource
CVN
Imaging Library
JACC Imaging
JACC Interventions

Click here for more guidelines.
2009 Focused Updates: ACC/AHA Guidelines for STEMI and ACC/AHA/SCAI Guidelines for PCI
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
ACC 2009 Advocacy Position Statement: Principles for Comparative Effectiveness Research
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2003; 41:105-112
© 2003 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zittermann, A.
Right arrow Articles by Stehle, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zittermann, A.
Right arrow Articles by Stehle, P.

CLINICAL STUDY: HEART FAILURE

Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?

Armin Zittermann, PhD*,*, Stefanie Schulze Schleithoff*, Gero Tenderich, MD{dagger}, Heiner K. Berthold, MD, PhD{ddagger}, Reiner Körfer, MD{dagger} and Peter Stehle, PhD*

* Department of Nutrition Science, University of Bonn, Germany
{dagger} Heart and Diabetes Center North Rhine-Westfalia, Department of Thoracic and Cardiovascular Surgery, Ruhr-University of Bochum, Bad Oeynhausen, Germany
{ddagger} Center for Cardiovascular Diseases, Department Clinical Pharmacology, Rotenburg a.d. Fulda, Germany

Manuscript received January 25, 2002; revised manuscript received August 19, 2002, accepted September 13, 2002.

* Reprint requests and correspondence: Dr. Armin Zittermann, Associate Professor, Department of Nutrition Science, University of Bonn, Endenicher Allee 11-13, 53115 Bonn, Germany.
a.zittermann{at}uni-bonn.de

OBJECTIVES: This study was designed to evaluate the association between vitamin D status and congestive heart failure (CHF).

BACKGROUND: Impaired intracellular calcium metabolism is an important factor in the pathogenesis of CHF. The etiology of CHF, however, is not well understood.

METHODS: Twenty patients age <50 years and 34 patients age ≥50 years with New York Heart Association classes ≥2 and 34 control subjects age ≥50 years were recruited. N-terminal pro-atrial natriuretic peptide (NT-proANP), a predictor of CHF severity; vitamin D metabolites; and parameters of calcium metabolism were measured in fasting blood samples collected between November 2000 and March 2001.

RESULTS: Both groups of CHF patients had markedly increased serum levels of NT-proANP (p < 0.001), increased serum phosphorus levels (p < 0.001), and reduced circulating levels of both 25-hydroxyvitamin D (p < 0.001) and calcitriol (p < 0.001). Albumin-corrected calcium levels were reduced and parathyroid hormone levels were increased in the younger CHF patients compared with the controls (both p values <0.001). Moreover, parathyroid hormone levels tended to be higher in the elderly CHF patients than in the controls (p = 0.074). In a nonlinear regression analysis 25-hydroxyvitamin D and calcitriol were inversely correlated with NT-proANP (r2 = 0.16; p < 0.001 and r2 = 0.12; p < 0.01, respectively). The vitamin D genotype at the BmsI restriction site did not differ between the study groups.

CONCLUSIONS: The low vitamin D status can explain alterations in mineral metabolism as well as myocardial dysfunction in the CHF patients, and it may therefore be a contributing factor in the pathogenesis of CHF.

Abbreviations and Acronyms
  Ca2+
  ionized calcium
  CHF
  congestive heart failure
  CI
  cardiac index
  LVEF
  left ventricular ejection fraction
  NT-proANP
  N-terminal pro-ANP
  NYHA
  New York Heart Association
  25OHD
  25-hydroxyvitamin D
  PCWP
  pulmonary wedge pressure
  PTH
  parathyroid hormone
  TNF
  tumor necrosis factor
  UV
  ultraviolet
  VDR
  vitamin D receptor




This article has been cited by other articles:


Home page
 HeartHome page
C J Ferro, C D Chue, R P Steeds, and J N Townend
Is lowering phosphate exposure the key to preventing arterial stiffening with age?
Heart, November 1, 2009; 95(21): 1770 - 1772.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
V. Soukoulis, J. B. Dihu, M. Sole, S. D. Anker, J. Cleland, G. C. Fonarow, M. Metra, E. Pasini, T. Strzelczyk, H. Taegtmeyer, et al.
Micronutrient deficiencies an unmet need in heart failure.
J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1660 - 1673.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
A. Kilkkinen, P. Knekt, A. Aro, H. Rissanen, J. Marniemi, M. Heliovaara, O. Impivaara, and A. Reunanen
Vitamin D Status and the Risk of Cardiovascular Disease Death
Am. J. Epidemiol., October 15, 2009; 170(8): 1032 - 1039.
[Abstract] [Full Text] [PDF]

Home page
 JAOA: Journal of the American Osteopathic AssociationHome page
D. A. Mowry, M. M. Costello, and K. A. Heelan
Association Among Cardiorespiratory Fitness, Body Fat, and Bone Marker Measurements in Healthy Young Females
J Am Osteopath Assoc, October 1, 2009; 109(10): 534 - 539.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. P. Reis, D. von Muhlen, E. R. Miller III, E. D. Michos, and L. J. Appel
Vitamin D Status and Cardiometabolic Risk Factors in the United States Adolescent Population
Pediatrics, September 1, 2009; 124(3): e371 - e379.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
A. Covic, P. Kothawala, M. Bernal, S. Robbins, A. Chalian, and D. Goldsmith
Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease
Nephrol. Dial. Transplant., May 1, 2009; 24(5): 1506 - 1523.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
I. Tastan, R. Schreckenberg, S. Mufti, Y. Abdallah, H. M. Piper, and K.-D. Schluter
Parathyroid hormone improves contractile performance of adult rat ventricular cardiomyocytes at low concentrations in a non-acute way
Cardiovasc Res, April 1, 2009; 82(1): 77 - 83.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
K. T. Weber, W. B. Weglicki, and R. U. Simpson
Macro- and micronutrient dyshomeostasis in the adverse structural remodelling of myocardium
Cardiovasc Res, February 15, 2009; 81(3): 500 - 508.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
P. J. Matias, C. Ferreira, C. Jorge, M. Borges, I. Aires, T. Amaral, C. Gil, J. Cortez, and A. Ferreira
25-Hydroxyvitamin D3, arterial calcifications and cardiovascular risk markers in haemodialysis patients
Nephrol. Dial. Transplant., February 1, 2009; 24(2): 611 - 618.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
R. N. Foley, A. J. Collins, C. A. Herzog, A. Ishani, and P. A. Kalra
Serum Phosphorus Levels Associate with Coronary Atherosclerosis in Young Adults
J. Am. Soc. Nephrol., February 1, 2009; 20(2): 397 - 404.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
A. Y.-M. Wang, J. E Sanderson, M. Wang, S.-F. Lui, M. M.-M. Sea, J. Woo, C. W.-K. Lam, and I. H.-S. Chan
Reply to C Fourtounas and JG Vlachojannis
Am. J. Clinical Nutrition, January 1, 2009; 89(1): 436 - 438.
[Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
J. P Reis, E. D Michos, D. von Muhlen, and E. R Miller III
Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease
Am. J. Clinical Nutrition, December 1, 2008; 88(6): 1469 - 1477.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
S. van Diepen, S. R. Majumdar, J. A. Bakal, F. A. McAlister, and J. A. Ezekowitz
Heart Failure Is a Risk Factor for Orthopedic Fracture: A Population-Based Analysis of 16 294 Patients
Circulation, November 4, 2008; 118(19): 1946 - 1952.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
S. Pilz, W. Marz, B. Wellnitz, U. Seelhorst, A. Fahrleitner-Pammer, H. P. Dimai, B. O. Boehm, and H. Dobnig
Association of Vitamin D Deficiency with Heart Failure and Sudden Cardiac Death in a Large Cross-Sectional Study of Patients Referred for Coronary Angiography
J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 3927 - 3935.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
D. E. Wallis, S. Penckofer, and G. W. Sizemore
The "Sunshine Deficit" and Cardiovascular Disease
Circulation, September 30, 2008; 118(14): 1476 - 1485.
[Full Text] [PDF]

Home page
 Arch Intern MedHome page
M. L. Melamed, E. D. Michos, W. Post, and B. Astor
25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population
Arch Intern Med, August 11, 2008; 168(15): 1629 - 1637.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Pharmacy PracticeHome page
A. B. Pai and T. A. Conner
Oxidative Stress and Inflammation in Chronic Kidney Disease: Role of Intravenous Iron and Vitamin D
Journal of Pharmacy Practice, June 1, 2008; 21(3): 214 - 224.
[Abstract] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
M. L. Melamed, P. Muntner, E. D. Michos, J. Uribarri, C. Weber, J. Sharma, and P. Raggi
Serum 25-Hydroxyvitamin D Levels and the Prevalence of Peripheral Arterial Disease: Results from NHANES 2001 to 2004
Arterioscler Thromb Vasc Biol, June 1, 2008; 28(6): 1179 - 1185.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
K. T Weber, R. U Simpson, and L. D Carbone
Vitamin D and calcium dyshomoeostasis-associated heart failure
Heart, May 1, 2008; 94(5): 540 - 541.
[Full Text] [PDF]

Home page
 Eur J Heart FailHome page
A. Zittermann, S. S. Schleithoff, C. Gotting, O. Dronow, U. Fuchs, J. Kuhn, K. Kleesiek, G. Tenderich, and R. Koerfer
Poor outcome in end-stage heart failure patients with low circulating calcitriol levels
Eur J Heart Fail, March 1, 2008; 10(3): 321 - 327.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
T. J. Wang, M. J. Pencina, S. L. Booth, P. F. Jacques, E. Ingelsson, K. Lanier, E. J. Benjamin, R. B. D'Agostino, M. Wolf, and R. S. Vasan
Vitamin D Deficiency and Risk of Cardiovascular Disease
Circulation, January 29, 2008; 117(4): 503 - 511.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
M. Chonchol, M. Cigolini, and G. Targher
Association between 25-hydroxyvitamin D deficiency and cardiovascular disease in type 2 diabetic patients with mild kidney dysfunction
Nephrol. Dial. Transplant., January 1, 2008; 23(1): 269 - 274.
[Abstract] [Full Text] [PDF]

Home page
 Clin Med ResHome page
S. Alsafwah, S. P. LaGuardia, M. Arroyo, B. K. Dockery, S. K. Bhattacharya, R. A. Ahokas, and K. P. Newman
Congestive Heart Failure is a Systemic Illness: A Role for Minerals and Micronutrients
Clin. Med. Res., December 1, 2007; 5(4): 238 - 243.
[Abstract] [Full Text] [PDF]

Home page
 Proc. Natl. Acad. Sci. USAHome page
N. Bodyak, J. C. Ayus, S. Achinger, V. Shivalingappa, Q. Ke, Y.-S. Chen, D. L. Rigor, I. Stillman, H. Tamez, P. E. Kroeger, et al.
Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals
PNAS, October 23, 2007; 104(43): 16810 - 16815.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. F. Holick
Vitamin D Deficiency
N. Engl. J. Med., July 19, 2007; 357(3): 266 - 281.
[Full Text] [PDF]

Home page
 Arch Intern MedHome page
D. Martins, M. Wolf, D. Pan, A. Zadshir, N. Tareen, R. Thadhani, A. Felsenfeld, B. Levine, R. Mehrotra, and K. Norris
Prevalence of Cardiovascular Risk Factors and the Serum Levels of 25-Hydroxyvitamin D in the United States: Data From the Third National Health and Nutrition Examination Survey
Arch Intern Med, June 11, 2007; 167(11): 1159 - 1165.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
R. Dhingra, L. M. Sullivan, C. S. Fox, T. J. Wang, R. B. D'Agostino Sr, J. M. Gaziano, and R. S. Vasan
Relations of Serum Phosphorus and Calcium Levels to the Incidence of Cardiovascular Disease in the Community
Arch Intern Med, May 14, 2007; 167(9): 879 - 885.
[Abstract] [Full Text] [PDF]

Home page
 cfpHome page
G. Schwalfenberg
Not enough vitamin D: Health consequences for Canadians
Can Fam Physician, May 1, 2007; 53(5): 841 - 854.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
E. D. Michos and R. S. Blumenthal
Vitamin D Supplementation and Cardiovascular Disease Risk
Circulation, February 20, 2007; 115(7): 827 - 828.
[Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
G. M. London, A. P. Guerin, F. H. Verbeke, B. Pannier, P. Boutouyrie, S. J. Marchais, and F. Metivier
Mineral Metabolism and Arterial Functions in End-Stage Renal Disease: Potential Role of 25-Hydroxyvitamin D Deficiency
J. Am. Soc. Nephrol., February 1, 2007; 18(2): 613 - 620.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Heart FailHome page
H. F. Saadi, E. Kazzam, B. A. Ghurbana, and M. G. Nicholls
Hypothesis: Correction of low vitamin D status among Arab women will prevent heart failure and improve cardiac function in established heart failure
Eur J Heart Fail, November 1, 2006; 8(7): 694 - 696.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
Y. Sun, R. A. Ahokas, S. K. Bhattacharya, I. C. Gerling, L. D. Carbone, and K. T. Weber
Oxidative stress in aldosteronism
Cardiovasc Res, July 15, 2006; 71(2): 300 - 309.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
S. S Schleithoff, A. Zittermann, G. Tenderich, H. K Berthold, P. Stehle, and R. Koerfer
Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial.
Am. J. Clinical Nutrition, April 1, 2006; 83(4): 754 - 759.
[Abstract] [Full Text] [PDF]

Home page
 J. Nutr.Home page
S. S. Harris
Vitamin D and African Americans
J. Nutr., April 1, 2006; 136(4): 1126 - 1129.
[Abstract] [Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
M. F. Holick
High Prevalence of Vitamin D Inadequacy and Implications for Health
Mayo Clin. Proc., March 1, 2006; 81(3): 353 - 373.
[Abstract] [Full Text] [PDF]

Home page
 AJPHHome page
C. F. Garland, F. C. Garland, E. D. Gorham, M. Lipkin, H. Newmark, S. B. Mohr, and M. F. Holick
The Role of Vitamin D in Cancer Prevention
Am J Public Health, February 1, 2006; 96(2): 252 - 261.
[Abstract] [Full Text] [PDF]

Home page
 J. Nutr.Home page
M. F. Holick
The Vitamin D Epidemic and its Health Consequences
J. Nutr., November 1, 2005; 135(11): 2739S - 2748S.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. Tonelli, F. Sacks, M. Pfeffer, Z. Gao, G. Curhan, and for the Cholesterol And Recurrent Events (CARE) Tr
Relation Between Serum Phosphate Level and Cardiovascular Event Rate in People With Coronary Disease
Circulation, October 25, 2005; 112(17): 2627 - 2633.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
P. H. Law, Y. Sun, S. K. Bhattacharya, V. S. Chhokar, and K. T. Weber
Diuretics and Bone Loss in Rats With Aldosteronism
J. Am. Coll. Cardiol., July 5, 2005; 46(1): 142 - 146.
[Abstract] [Full Text] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
R. Vieth, R. Scragg, P.E. Norman, and J.T. Powell
Vitamin D Nutrition Does Not Cause Peripheral Artery Disease
Arterioscler Thromb Vasc Biol, May 1, 2005; 25(5): e41 - e42.
[Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
M. Teng, M. Wolf, M. N. Ofsthun, J. M. Lazarus, M. A. Hernan, C. A. Camargo Jr, and R. Thadhani
Activated Injectable Vitamin D and Hemodialysis Survival: A Historical Cohort Study
J. Am. Soc. Nephrol., April 1, 2005; 16(4): 1115 - 1125.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
V. S. Chhokar, Y. Sun, S. K. Bhattacharya, R. A. Ahokas, L. K. Myers, Z. Xing, R. A. Smith, I. C. Gerling, and K. T. Weber
Hyperparathyroidism and the Calcium Paradox of Aldosteronism
Circulation, February 22, 2005; 111(7): 871 - 878.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
V. S. Chhokar, Y. Sun, S. K. Bhattacharya, R. A. Ahokas, L. K. Myers, Z. Xing, R. A. Smith, I. C. Gerling, and K. T. Weber
Loss of bone minerals and strength in rats with aldosteronism
Am J Physiol Heart Circ Physiol, November 1, 2004; 287(5): H2023 - H2026.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
N. Binkley, D. Krueger, C. S. Cowgill, L. Plum, E. Lake, K. E. Hansen, H. F. DeLuca, and M. K. Drezner
Assay Variation Confounds the Diagnosis of Hypovitaminosis D: A Call for Standardization
J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3152 - 3157.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
M. F Holick
Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis
Am. J. Clinical Nutrition, March 1, 2004; 79(3): 362 - 371.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
J. Robson
What happened to evidence in NICE guidance on heart failure?
BMJ, October 18, 2003; 327(7420): 932 - 932.
[Full Text]


 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement