PMID- 21304056
OWN - NLM
STAT- MEDLINE
DCOM- 20120213
LR  - 20110808
IS  - 1940-4034 (Electronic)
IS  - 1074-2484 (Linking)
VI  - 16
IP  - 3-4
DP  - 2011 Sep-Dec
TI  - Is vitamin D deficiency associated with heart failure? A review of current 
      evidence.
PG  - 354-63
LID - 10.1177/1074248410390214 [doi]
AB  - An estimated 1 billion people worldwide have deficient or insufficient levels of 
      vitamin D. Even more alarming is the association of vitamin D deficiency with 
      many types of diseases, particularly heart failure (HF). Hypovitaminosis D has 
      been observed to be highly prevalent in the HF community with rates varying from 
      approximately 80% to 95%. Higher rates of deficiency have been linked to winter 
      months, in patients with protracted decompensated HF, darker skin pigmentation, 
      and higher New York Heart Association (NYHA) classes. In fact, some data suggest 
      vitamin D deficiency may even be an independent predictor of mortality in 
      patients with HF. Traditionally obtained through UV exposure and activated in the 
      liver and then the kidneys, vitamin D is classified as a vitamin but functions as 
      a steroid hormone. The hormone acts through the vitamin D receptor (VDR), which 
      is expressed in vascular smooth muscle cells, renal juxtaglomerular cells, and 
      most interestingly, cardiac myocytes. Studies have shown that the association 
      between vitamin D deficiency and HF often manifests in the structural components 
      of cardiac myocytes and/or through alterations of the neurohormonal cascade. In 
      addition, vitamin D may also act rapidly through intracellular nongenomic 
      receptors that alter cardiac contractility. Unfortunately, prospective vitamin D 
      supplementation trials show mixed results. In rat models, successful correction 
      of deficiency was associated with reductions in ventricular hypertrophy. In 
      humans, however, echocardiographic dimensions did not change significantly. These 
      results bring into questions whether vitamin D is a risk factor for HF, a marker 
      of HF disease severity, or has a true pathologic role. This article provides a 
      thorough review of vitamin D deficiency etiology, prevalence, and possible 
      pathophysiologic role in HF. Furthermore, we carefully review prospective trials 
      on vitamin D therapy in HF. We believe more trials on vitamin D therapy in HF 
      need to be conducted before any conclusions can be drawn.
FAU - Agarwal, Megha
AU  - Agarwal M
AD  - Cedars Sinai Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA. 
      agarwalm@cshs.org
FAU - Phan, Anita
AU  - Phan A
FAU - Willix, Robert Jr
AU  - Willix R Jr
FAU - Barber, Mickey
AU  - Barber M
FAU - Schwarz, Ernst R
AU  - Schwarz ER
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20110208
PL  - United States
TA  - J Cardiovasc Pharmacol Ther
JT  - Journal of cardiovascular pharmacology and therapeutics
JID - 9602617
RN  - 0 (Vitamins)
RN  - 1406-16-2 (Vitamin D)
SB  - IM
MH  - Animals
MH  - Drug Evaluation, Preclinical
MH  - Heart Failure/complications/*epidemiology/etiology/metabolism
MH  - Humans
MH  - Rats
MH  - Vitamin D/genetics/metabolism/physiology/*therapeutic use
MH  - Vitamin D Deficiency/complications/drug therapy/*epidemiology/physiopathology
MH  - Vitamins/genetics/metabolism/physiology/*therapeutic use
EDAT- 2011/02/10 06:00
MHDA- 2012/02/14 06:00
CRDT- 2011/02/10 06:00
PHST- 2011/02/10 06:00 [entrez]
PHST- 2011/02/10 06:00 [pubmed]
PHST- 2012/02/14 06:00 [medline]
AID - 1074248410390214 [pii]
AID - 10.1177/1074248410390214 [doi]
PST - ppublish
SO  - J Cardiovasc Pharmacol Ther. 2011 Sep-Dec;16(3-4):354-63. doi: 
      10.1177/1074248410390214. Epub 2011 Feb 8.