Key result
Lower Vitamin D3 in African Americans links to greater LV remodeling and higher HFpEF risk.
Why the study?
Associations between serum vitamin D3 levels, LV structure and function, and HFpEF are not well-characterized, particularly among African Americans who have a higher prevalence of deficiency.
Are lower serum Vitamin D3 levels associated with left ventricular concentric remodeling and incident heart failure in African Americans?
Cohort (n=4,872)
Are lower serum Vitamin D3 levels associated with left ventricular concentric remodeling and incident heart failure in African Americans?
In an African American cohort, lower serum Vitamin D3 levels were associated with left ventricular concentric remodeling and an increased risk of incident heart failure, particularly HFpEF.
Hypothesis-generating for vitamin D in African American HFpEF risk; leaves open whether supplementation alters remodeling or incidence.
Background: Lower serum vitamin D3 (VitD3) concentration has been associated with cardiovascular disease. However, the associations between serum VitD3 levels and left ventricular (LV) structure and function and heart failure with preserved ejection fraction (HFpEF) have not been well-characterized community. The prevalence of VitD3 deficiency is higher among African Americans than in other race/ethnicity groups. We hypothesized that serum VitD3 levels are associated with LV concentric remodeling and incident heart failure (HF) in African Americans. Methods and Results: Among 4872 African Americans in the Jackson Heart Study cohort, we investigated the relationships between serum VitD3 levels and LV structure and function, evaluated with echocardiography, and incident HF hospitalization, categorized either HF with reduced EF (HFrEF: EF<50%) or HFpEF (EF≥50%). The median and interquartile serum VitD3 levels were 12.0 (8.6-16.7) ng/mL. After adjustment for age, sex, body mass index, systolic blood pressure, anti-hypertensive medication use, current smoking status, and estimated glomerular filtration rate, lower VitD3 levels were associated with greater septal and posterior wall thickness and plasma brain natriuretic peptide (BNP) levels, but not with LV mass index or LVEF (Table). Over a median follow-up period of 11 (10.3~11) years, 313 participants developed incident HF (7.79 cases per 1,000 person-years), including 128 (41%) HFrEF and 185 (59%) HFpEF cases. After adjustment, lower serum VitD3 levels were associated with higher incidence of HF overall and levels seemed to be mostly related to HFpEF (Table). Conclusion: In this community-based African American cohort, lower serum VitD3 levels were associated with LV concentric remodeling and incident HF, mainly HFpEF. Further investigation is required to examine whether the supplementation of VitD3 can prevent LV concentric remodeling and incident HFpEF in African Americans.
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Kamimura et al. (2020) conducted a cohort in Heart failure and left ventricular structure (n=4,872). Serum Vitamin D3 levels was evaluated on Incident heart failure hospitalization and left ventricular structure/function. Lower serum Vitamin D3 levels in African Americans were associated with greater left ventricular concentric remodeling and a higher incidence of incident heart failure, primarily HFpEF.
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