Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vitamin D is an important prohormone for optimal intestinal calcium absorption for mineralization of bone. Because the vitamin D receptor is present in multiple tissues, there has been interest in evaluating other potential functions of vitamin D, particularly, in cardiovascular diseases (CVD). Cross-sectional studies have reported that vitamin D deficiency is associated with increased risk of CVD, including hypertension, heart failure, and ischemic heart disease. Initial prospective studies have also demonstrated that vitamin D deficiency increases the risk of developing incident hypertension or sudden cardiac death in individuals with preexisting CVD. Very few prospective clinical studies have been conducted to examine the effect of vitamin D supplementation on cardiovascular outcomes. The mechanism for how vitamin D may improve CVD outcomes remains obscure; however, potential hypotheses include the downregulation of the renin-angiotensin-aldosterone system, direct effects on the heart, and vasculature or improvement of glycemic control. This review will examine the epidemiologic and clinical evidence for vitamin D deficiency as a cardiovascular risk factor and explore potential mechanisms for the cardioprotective effect of vitamin D.
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PMID:Vitamin D deficiency and risk for cardiovascular disease. 1959 2

Exposure of the skin to sunlight is now considered the most important source of vitamin D in Western countries. It is presumed to contribute approximately two thirds of the total requirement, leaving the remaining one third to the few foods naturally rich in this vitamin. In the skin, vitamin D is synthesized as a cholesterol chain which undergoes structural modifications following exposure to UVB rays. Once produced in the skin or absorbed in the gut as cholecalciferol, vitamin D enters the blood to be transported by a specific vitamin D binding protein, which is synthesized in the liver and has a powerful buffering capacity. The transport system carries the metabolites to the sites of further activation (25-hydroxylation in the liver and 1alpha-hydroxylation in the kidney), ultimately resulting in the production of calcitriol. This last compound, now regarded as a hormone, circulates freely in minimal amounts and, compared with the other metabolites, shows the highest affinity for the vitamin D receptor (VDR). The mechanism of VDR activation is rather complex, resulting in either stimulation or inhibition of protein synthesis. Importantly, besides its presence in parathyroid, bone, kidney and intestine, this receptor has been demonstrated in several tissues, where its stimulation results in a reduced proliferation rate and increased differentiation. Accordingly, vitamin D is now regarded as a complex hormonal system, involved not only in the regulation of divalent ions and bone, but also in the proliferation and differentiation of numerous cell types with potential involvement in several diseases like cancer, immune diseases, diabetes, hypertension and heart failure.
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PMID:[Understanding the different functions of vitamin D]. 1964 19

Epilepsy is the most common serious neurological condition and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but high seizure frequency is a potential risk factor. Additionally, potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures or transmission of epileptic activity to the heart via the autonomic nervous system potentially play a role. In parallel, studies have shown a link between vitamin D dysfunction and epilepsy. Moreover, several evidences in the literature suggest an association between low vitamin D and seizures, indicating the possibility of anticonvulsant properties of this hormone. Quite interesting, a growing body of data suggests that low vitamin D levels may adversely affect cardiovascular health, directly associated with death from heart failure and sudden cardiac death. In view of the above findings, our research group focused in this review article that SUDEP, at least in some cases, could be related with low vitamin D levels.
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PMID:Benefits of sunlight: vitamin D deficiency might increase the risk of sudden unexpected death in epilepsy. 1966 11

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)D(3) 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)D(3) 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)D(3) 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.
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PMID:Calcium and vitamin D status in heart failure patients in Isfahan, Iran. 1969 Aug 19

Hypocalcaemia is a rare cause of reversible heart failure. We present a 27-year-old man who had severe heart failure unresponsive to medical therapy. He had vitamin D-resistant rickets for which he had received replacement therapy with vitamin D and calcium until age 20, but he discontinued treatment for the past seven years. Severe hypocalcemia was detected. Echocardiography showed left ventricular dilatation, global hypokinesia (ejection fraction 25%), and mitral and tricuspid regurgitation of grades 3 and 2, respectively. After calcium and vitamin D supplementation, his symptoms showed rapid improvement. At nine months, myocardial dysfunction improved fully. Hypocalcemia should be considered among the causes of heart failure unresponsive to medical treatment.
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PMID:[A rare cause of reversible dilated cardiomyopathy: hypocalcemia]. 1971 62

Vitamin D deficiency is common among patients with myocardial diseases because sun-induced vitamin D production in the skin and dietary intake of vitamin D is often insufficient. Knockout mice for the vitamin D receptor develop myocardial hypertrophy and dysfunction. It has also been shown that children with rickets who suffered from severe heart failure could be successfully treated with supplementation of vitamin D plus calcium. In adults, almost all patients with heart failure exhibit reduced 25-hydroxyvitamin D levels, which are used to classify the vitamin D status. In prospective studies, vitamin D deficiency was an independent risk factor for mortality, deaths due to heart failure and sudden cardiac death. Several vitamin D effects on the electrophysiology, contractility, and structure of the heart suggest that vitamin D deficiency might be a causal factor for myocardial diseases. Data from interventional trials, however, are rare and urgently needed to elucidate whether vitamin D supplementation is useful for the treatment of myocardial diseases. In our opinion, the current knowledge of the beneficial effects of vitamin D on myocardial and overall health strongly argue for vitamin D supplementation in all vitamin D-deficient patients with or at high risk for myocardial diseases.
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PMID:Vitamin D deficiency and myocardial diseases. 2035 23

Cachexia is an illness that may occur in terminal stages of many chronic illnesses including cancer, chronic heart failure, chronic renal failure or chronic obstructive pulmonary disease. Effective treatments are urgently needed in order to improve the patients' quality of life and their survival. We report highlights from the 5th Cachexia Conference held in December 2009 in Barcelona, Spain. Novel therapeutic approaches shown here include melanocortin-4 receptor antagonists, myostatin inhibition, beta-blockers, IL-6 antagonism synthetic ghrelin and vitamin D.
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PMID:Novel treatment approaches to cachexia and sarcopenia: highlights from the 5th Cachexia Conference. 2036 96

Dilated cardiomyopathy is an important cause of heart failure in children. Often it requires transplantation, but on rare occasions it is curable by micronutrient supplementation. Hypocalcemic nutritional rickets was found to be a cause for dilated cardiomyopathy in a 15-month-old child. The patient responded to calcium and vitamin D supplementation promptly and left ventricular systolic function normalized after 3 months of treatment. Nutritional rickets must the considered as an important curable cause for dilated cardiomyopathy among children especially in regions where nutritional rickets is still common.
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PMID:Hypocalcemia nutritional rickets: a curable cause of dilated cardiomyopathy. 2055 14

The increasing worldwide displacement from the natural outdoor environment of human beings to an indoor sedentary lifestyle, along with the recommendation to avoid any direct sun exposure because of the risk of skin cancer, has resulted in a global pandemic of vitamin D insufficiency. Traditionally, vitamin D has been associated primarily with bone health. However, it has become evident that adequate vitamin D status is important for optimal function of many organs and tissues throughout the body, including the cardiovascular system. Vitamin D insufficiency seems to predispose to hypertension, diabetes and the metabolic syndrome, left ventricular hypertrophy, heart failure, and chronic vascular inflammation. The relationship between baseline vitamin D status, dose of vitamin D supplements, and cardiovascular events remains to be investigated by ongoing randomized trials; however increasing evidence suggests that the provision of a simple, well-tolerated, and inexpensive correction of vitamin D insufficiency favourably affects the morbility and mortality of cardiovascular disease along with the prevention of the most common chronic degenerative diseases.
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PMID:[Vitamin D deficiency and cardiovascular diseases]. 2059 17

Hypocalcemia is a rare cause of dilated cardiomyopathy. Hypocalcemia induced cardiomyopathy is usually reversible when calcium level returns to normal range. We experienced a case of 57-year-old woman who had suffered from hypocalcemia after total thyroidectomy and its consequence of dilated cardiomyopathy. After supplementation of calcium and vitamin D, symptoms of heart failure and LV function were recovered.
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PMID:A case of hypocalcemia-induced dilated cardiomyopathy. 2066 33


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