Skip to main content
Top
Published in: Pediatric Cardiology 5/2012

01-06-2012 | Original Article

Vitamin D Supplementation in Infants With Chronic Congestive Heart Failure

Author: Soad A. Shedeed

Published in: Pediatric Cardiology | Issue 5/2012

Login to get access

Abstract

Increased circulating proinflammatory cytokines may contribute to the pathogenesis of congestive heart failure (CHF). In vitro studies have suggested that vitamin D suppresses proinflammatory cytokines and increases anti-inflammatory cytokines. The aim of this work was to evaluate the effect of vitamin D supplementation on renin-angiotensin system cytokines as well as different clinical, biochemical, and echocardiographic variables in infants with chronic CHF. This was a double-blind, placebo-controlled intervention study and included 80 infants with CHF. The intervention consisted of either giving Vitamin D3 oral drops (group I) or placebo oral drops (group II). In both study groups, baseline 25-hydroxyvitamin D [25(OH)D] concentrations were below the lower end of the reference range. After 12 weeks of intervention, vitamin D supplementation for group I infants caused significant improvement of HF score, left-ventricular (LV) end-diastolic diameter, LV end-systolic diameter, LV ejection fraction%, and myocardial performance index together with markedly increased serum 25(OH)D and interleukin (IL)-10 and decreased PTH, IL-6, and TNF-α compared with the placebo group; these differences were statistically significant (p < 0.001). Vitamin D supplementation has great benefits as an anti-inflammatory agent in infants with CHF. It helps acceleration of the clinical improvement and cytokine profile balance.
Literature
1.
go back to reference Bodyak N, Ayus JC, Achinger S (2007) Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals. Proc Natl Acad Sci USA 104:16810–16815PubMedCrossRef Bodyak N, Ayus JC, Achinger S (2007) Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals. Proc Natl Acad Sci USA 104:16810–16815PubMedCrossRef
2.
go back to reference Canning MO, Grotenhuis K, de Wit H, Ruwhof C, Drexhage HA (2001) 1-alpha,25-Dihydroxyvitamin D3 (1,25(OH)(2)D(3)) hampers the maturation of fully active immature dendritic cells from monocytes. Eur J Endocrinol 145:351–357PubMedCrossRef Canning MO, Grotenhuis K, de Wit H, Ruwhof C, Drexhage HA (2001) 1-alpha,25-Dihydroxyvitamin D3 (1,25(OH)(2)D(3)) hampers the maturation of fully active immature dendritic cells from monocytes. Eur J Endocrinol 145:351–357PubMedCrossRef
3.
go back to reference DeVries JE (1995) Immunosuppressive and anti-inflammatory properties of interleukin 10. Ann Med 27:537–541CrossRef DeVries JE (1995) Immunosuppressive and anti-inflammatory properties of interleukin 10. Ann Med 27:537–541CrossRef
4.
go back to reference Hollycross BJ, Judith Radin M (2010) Cytokines in heart failure: potential interactions with angiotensin II and leptin. Mol Interv 5:1543–1546 Hollycross BJ, Judith Radin M (2010) Cytokines in heart failure: potential interactions with angiotensin II and leptin. Mol Interv 5:1543–1546
5.
go back to reference Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ (2008) Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol 102:1540–1544PubMedCrossRef Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ (2008) Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol 102:1540–1544PubMedCrossRef
6.
go back to reference Koller-Strametz J, Pacher R, Frey B, Kos T, Woloszczuk W, Stanek B (1998) Circulating tumor necrosis factor-alpha levels in chronic heart failure: relation to its soluble receptor II, interleukin-6, and neurohumoral variables. J Heart Lung Transpl 17:356–362 Koller-Strametz J, Pacher R, Frey B, Kos T, Woloszczuk W, Stanek B (1998) Circulating tumor necrosis factor-alpha levels in chronic heart failure: relation to its soluble receptor II, interleukin-6, and neurohumoral variables. J Heart Lung Transpl 17:356–362
7.
go back to reference Lee JH, O’Keefe JH, Bell D, Hensrud DD, Holick MF (2008) Vitamin D deficiency: an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol 52:1949–1956PubMedCrossRef Lee JH, O’Keefe JH, Bell D, Hensrud DD, Holick MF (2008) Vitamin D deficiency: an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol 52:1949–1956PubMedCrossRef
8.
go back to reference Levine M, Nikkanen H, Pallin DJ (2009) The effects of intravenous calcium in patients with digoxin toxicity. J Emerg Med 18:413–417 Levine M, Nikkanen H, Pallin DJ (2009) The effects of intravenous calcium in patients with digoxin toxicity. J Emerg Med 18:413–417
9.
go back to reference Rauchhaus M, Doehner W, Francis DP (2000) Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 102:3060–3067PubMed Rauchhaus M, Doehner W, Francis DP (2000) Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 102:3060–3067PubMed
10.
go back to reference Ross RD, Bollinger RO, Pinsky WW (1992) Grading the severity of congestive heart failure in infants. Pediatr Cardiol 13:72–75PubMedCrossRef Ross RD, Bollinger RO, Pinsky WW (1992) Grading the severity of congestive heart failure in infants. Pediatr Cardiol 13:72–75PubMedCrossRef
11.
go back to reference Rostand SG, Drueke TB (1999) Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failure. Kidney Int 56:383–392PubMedCrossRef Rostand SG, Drueke TB (1999) Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failure. Kidney Int 56:383–392PubMedCrossRef
12.
go back to reference Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R (2006) Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 83:754–759PubMed Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R (2006) Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 83:754–759PubMed
13.
go back to reference Snider A, Serwer G, Ritter S (1996) Methods for obtaining quantitative information from echocardiographic examination. In: Snider A, Serwer G, Ritter S (eds) Echocardiography in pediatric heart disease, 2nd edn. Mosby, St. Louis, pp 133–243 Snider A, Serwer G, Ritter S (1996) Methods for obtaining quantitative information from echocardiographic examination. In: Snider A, Serwer G, Ritter S (eds) Echocardiography in pediatric heart disease, 2nd edn. Mosby, St. Louis, pp 133–243
14.
go back to reference Stoddard MF, Pearson AC, Kern MJ (2006) Influence of alteration in preload on the pattern of left ventricular diastolic filling as assessed by Doppler echocardiography in humans. Circulation 79:1226–1236CrossRef Stoddard MF, Pearson AC, Kern MJ (2006) Influence of alteration in preload on the pattern of left ventricular diastolic filling as assessed by Doppler echocardiography in humans. Circulation 79:1226–1236CrossRef
15.
go back to reference Tishkoff DX, Nibbelink KA, Holmberg KH, Dandu L, Simpson RU (2008) Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility. Endocrinology 149:558–564PubMedCrossRef Tishkoff DX, Nibbelink KA, Holmberg KH, Dandu L, Simpson RU (2008) Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility. Endocrinology 149:558–564PubMedCrossRef
16.
go back to reference Tomar M, Radhakrishnan S, Shrivastava S (2010) Myocardial dysfunction due to hypocalcemia. Indian Pediatr 47:781–783PubMedCrossRef Tomar M, Radhakrishnan S, Shrivastava S (2010) Myocardial dysfunction due to hypocalcemia. Indian Pediatr 47:781–783PubMedCrossRef
17.
go back to reference Wagner CL, Greer FR (2008) American Academy of Pediatrics, Section on Breastfeeding Medicine and Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents: new guidelines for vitamin D intake. Pediatrics 122:1142–1152PubMedCrossRef Wagner CL, Greer FR (2008) American Academy of Pediatrics, Section on Breastfeeding Medicine and Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents: new guidelines for vitamin D intake. Pediatrics 122:1142–1152PubMedCrossRef
18.
go back to reference Weber KT, Simpson RU, Carbone LD (2008) Vitamin D and calcium dyshomeostasis-associated heart failure. Heart 94:540–541PubMedCrossRef Weber KT, Simpson RU, Carbone LD (2008) Vitamin D and calcium dyshomeostasis-associated heart failure. Heart 94:540–541PubMedCrossRef
19.
go back to reference Zhu Y, Mahon BD, Froicu M, Cantorna MT (2005) Calcium and 1alpha,25-dihydroxyvitamin D3 target the TNF-alpha pathway to suppress experimental inflammatory bowel disease. Eur J Immunol 35:217–224PubMedCrossRef Zhu Y, Mahon BD, Froicu M, Cantorna MT (2005) Calcium and 1alpha,25-dihydroxyvitamin D3 target the TNF-alpha pathway to suppress experimental inflammatory bowel disease. Eur J Immunol 35:217–224PubMedCrossRef
20.
go back to reference Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Korfer R, Stehle P (2003) Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 41:105–112PubMedCrossRef Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Korfer R, Stehle P (2003) Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 41:105–112PubMedCrossRef
Metadata
Title
Vitamin D Supplementation in Infants With Chronic Congestive Heart Failure
Author
Soad A. Shedeed
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Pediatric Cardiology / Issue 5/2012
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-012-0199-6

Other articles of this Issue 5/2012

Pediatric Cardiology 5/2012 Go to the issue

Images in Pediatric Cardiology

Rare Anomaly of Great Arteries