Matter Mohamed, El-Sherbiny Enas, Elmougy Atef, Abass Mohamed, Aldossary Sahar, Ali Waleed Abu
Pediatric Department, Mansoura University Children Hospital, Mansoura Faculty of Medicine, Mansoura City, Egypt.
Community Medicine Department, Mansoura Faculty of Medicine, Mansoura City, Egypt.
J Saudi Heart Assoc. 2016 Jan;28(1):22-30. doi: 10.1016/j.jsha.2015.06.006. Epub 2015 Jun 26.
Vitamin D deficiency is a common health problem in Saudi Arabia especially in children and adolescents. Many studies have reported the relation between low 25-Hydroxyvitamin D (25(OH)D) levels with cardiovascular diseases risk factors as well as cardiovascular events, including stroke, myocardial infarction, and congestive heart failure. This study was conducted to evaluate the effect of 25(OH)D deficiency on the myocardial function and other echocardiographic variables in adolescent, using tissue Doppler imaging (TDI) and to correlate these parameters with 25(OH)D level. The study included 84 healthy adolescents, consecutively selected from adolescents attending the outpatient clinic of Saad Specialist Hospital, KSA between September 2013 and October 2014. The study population was classified into two groups; vitamin D deficient group with 25(OH)D level less than 20 ng/mL and normal vitamin D (control group) with 25(OH)D equal or more than 30 ng/mL. Both groups were subjected to measuring hemoglobin level, serum albumin, creatinine, total calcium, Phosphorous, intact parathyroid hormone (iPTH), B-type natriuretic peptide (BNP), and 25(OH)D levels. Both conventional and pulsed wave TDI were done for all participants. TDI measurements showed significant higher LV Tei Index and RV Tei index when compared to the control group (0.61 ± 0.11 Vs 0.32 ± 0.05 p < 0.0001), (0.54 ± 0.14 Vs 0.40 ± 0.06 p < 0.0001) respectively. Mitral and tricuspid annular systolic velocities were significantly lower in vitamin D deficient group (6.99 ± 1.92 Vs 10.69 ± 0.31 cm/sec p < 0.0001 and 12.30 ± 2.14 Vs 13.89 ± 0.29 p < 0.0001 respectively). The mitral and tricuspid E/Em ratio was significantly higher in vitamin D deficient group than control group (p < 0.0001, p 0.005) respectively. Left ventricular internal diameter at end-diastole (LVIDd) was significantly higher in vitamin D deficient group (44.72 ± 6.33 Vs 40.36 ± 6.21 p 0.003). Serum 25(OH)D level showed significant negative correlation with LV Tei index (r = -0.668, p < 0.0001), RV Tei index (r = -0.421, p < 0.0001). Vitamin D deficiency is associated with subtle systolic and diastolic myocardial dysfunction in Saudi adolescents. TDI is a useful tool for detecting early changes in the myocardium in this particular group.
维生素D缺乏是沙特阿拉伯常见的健康问题，尤其是在儿童和青少年中。许多研究报告了低25-羟基维生素D（25(OH)D）水平与心血管疾病危险因素以及心血管事件（包括中风、心肌梗死和充血性心力衰竭）之间的关系。本研究旨在使用组织多普勒成像（TDI）评估25(OH)D缺乏对青少年心肌功能和其他超声心动图变量的影响，并将这些参数与25(OH)D水平相关联。该研究纳入了84名健康青少年，他们是在2013年9月至2014年10月期间从沙特阿拉伯王国萨阿德专科医院门诊就诊的青少年中连续选取的。研究人群分为两组；25(OH)D水平低于20 ng/mL的维生素D缺乏组和25(OH)D等于或高于30 ng/mL的正常维生素D（对照组）。两组均进行血红蛋白水平、血清白蛋白、肌酐、总钙、磷、完整甲状旁腺激素（iPTH）、B型利钠肽（BNP）和25(OH)D水平的测量。所有参与者均进行了传统和脉冲波TDI检查。TDI测量显示，与对照组相比，左心室Tei指数和右心室Tei指数显著更高（分别为0.61±0.11对0.32±0.05，p<0.0001），（0.54±0.14对0.40±0.06，p<0.0001）。维生素D缺乏组的二尖瓣和三尖瓣环收缩速度显著更低（分别为6.99±1.92对10.69±0.31 cm/秒，p<0.0001和12.30±2.14对13.89±0.29，p<0.0001）。维生素D缺乏组的二尖瓣和三尖瓣E/Em比值分别显著高于对照组（p<0.0001，p 0.005）。维生素D缺乏组的舒张末期左心室内径（LVIDd）显著更高（44.72±6.33对40.36±6.21，p 0.003）。血清25(OH)D水平与左心室Tei指数（r=-0.668，p<0.0001）、右心室Tei指数（r=-0.421，p<0.0001）呈显著负相关。维生素D缺乏与沙特青少年轻微的收缩期和舒张期心肌功能障碍有关。TDI是检测该特定群体心肌早期变化的有用工具。
