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Combinatorial Chemistry & High Throughput Screening


ISSN (Print): 1386-2073
ISSN (Online): 1875-5402

Research Article

Relationship Between Vitamin D Level and Index of Cardio Electrophysiological Balance in Children

Author(s): Ahmet Guzelcicek*, Emrullah Kilinc, Halil Fedai, Necip Fazıl Dedeoglu, Kenan Toprak, Mustafa Begenc Tascanov, Metin Ocak, Bülent Gungorer and Dogan Kose

Volume 27, Issue 14, 2024

Published on: 15 February, 2024

Page: [2096 - 2100] Pages: 5

DOI: 10.2174/1386207326666230816094807


Background: Vitamin D deficiency has been found to be associated with various cardiovascular disorders, including hypertension, coronary artery disease, heart failure, peripheral vascular diseases, and sudden cardiac death. In the literature, it has been reported that many electrocardiographic parameters have been developed to predict ventricular arrhythmias. In recent studies, it is noteworthy that the index of cardio-electrophysiological balance (iCEB) and correct cardioelectrophysiological balance (iCEBc), which are electrocardiographic parameters, can be used as new, easy, cheap and non-invasive parameters to predict ventricular arrhythmias.

Objective: This study aimed to investigate the relationship between vitamin D deficiency and iCEB and iCEBc values in children.

Methods: A total of 186 patients were included in this study. Group 1 included 114 patients with vitamin D levels below 20 ng/ml; 50 patients with vitamin D levels of 21-29 ng/ml were included in Group 2; Group 3 consisted of 36 patients with a vitamin D level above 30 ng/ml. iCEB and iCEBc values were calculated by taking 12-lead ECG from all individuals and comparing them between groups.

Results: A total of 186 children, 114 subjects in Group 1, 36 subjects in Group 2, and 36 subjects in Group 3, were included in the study. Demographic characteristics and height-weight values of the groups were similar. Significant differences were found between the groups in terms of QT, QTc, QT/QRS, and QTc/QRS levels (p: 0.003, 0.028, 0.001, and 0.001, respectively). In the correlation analysis, a negative correlation was found between QTc/QRS and vitamin D level (r=-0.320, p=<0.001) and between QT/QRS and vitamin D level (r=-0.268, p=<0.001). Moreover, vitamin D level (β=0.389, p<0.001) was determined as an independent predictor of QTc/QRS in multivariate logistic regression analysis.

Conclusion: iCEB and iCEBc parameters increase significantly in children with low vitamin D levels. These parameters are also evaluated during the follow-up of children with vitamin D deficiency in terms of the risk of ventricular arrhythmia. iCEBc can be used as an easy, inexpensive, non-invasive, and reproducible parameter.

Keywords: Vitamin D deficiency, iCEB, ventricular arrhythmia, SCD, ECG, QTC.

Graphical Abstract
Rai, V.; Agrawal, D.K. Role of Vitamin D in Cardiovascular Diseases. Endocrinol. Metab. Clin. North Am., 2017, 46(4), 1039-1059.
[] [PMID: 29080634]
Reddy Vanga, S.; Good, M.; Howard, P.A.; Vacek, J.L. Role of vitamin D in cardiovascular health. Am. J. Cardiol., 2010, 106(6), 798-805.
[] [PMID: 20816120]
Cha, J.J.; Wi, J. Association of Vitamin D Deficiency with Profound Cardiogenic Shock in Patients Resuscitated From Sudden Cardiac Arrest. Shock, 2020, 53(6), 717-722.
[] [PMID: 31490356]
Bagrul, D.; Atik, F. Association of vitamin D deficiency with ventricular repolarization abnormalities. Kardiol. Pol., 2019, 77(9), 853-858.
[] [PMID: 31289258]
Anderson, J.L.; May, H.T.; Horne, B.D.; Bair, T.L.; Hall, N.L.; Carlquist, J.F.; Lappé, D.L.; Muhlestein, J.B. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am. J. Cardiol., 2010, 106(7), 963-968.
[] [PMID: 20854958]
Afsin, A.; Asoglu, R.; Kobat, M.A.; Asoglu, E.; Suner, A. Evaluation of index of cardio-electrophysiological balance in patients with atrial fibrillation on antiarrhythmic-drug therapy. Cardiol. Res., 2021, 12(1), 37-46.
[] [PMID: 33447324]
Askin, L.; Tanrıverdi, O. Evaluation of index of cardio-electrophysiological balance in patients with coronary slow flow. Acta Cardiol., 2022, 77(4), 337-341.
[] [PMID: 34218730]
Hemmeryckx, B.; Feng, Y.; Frederix, L.; Lox, M.; Trenson, S.; Vreeken, R.; Lu, H.R.; Gallacher, D.; Ni, Y.; Lijnen, H.R. Evaluation of cardiac arrhythmic risks using a rabbit model of left ventricular systolic dysfunction. Eur. J. Pharmacol., 2018, 832, 145-155.
[] [PMID: 29782862]
Alareedh, M.; Nafakhi, H.; Shaghee, F.; Nafakhi, A. Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID-19 pneumonia. Ann. Noninvasive Electrocardiol., 2021, 26(3), e12824.
[] [PMID: 33463863]
Asoglu, R.; Tibilli, H.; Asoglu, E.; Aladag, N.; Ozdemir, M.; Suner, A. Evaluation of index of cardiac electrophysiological balance in COVID-19 patients. Bratisl. Med. J., 2021, 122(8), 598-604.
[] [PMID: 34282628]
Neary, M.T.; Mohun, T.J.; Breckenridge, R.A. A mouse model to study the link between hypoxia, long QT interval and sudden infant death syndrome. Dis. Model. Mech., 2013, 6(2), 503-507.
[PMID: 22977222]
Tse, G.; Yan, B.P. Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death. Europace, 2017, 19(5), 712-721.
[] [PMID: 27702850]
Zorlu, Ç.; Ömür, S.E. Evaluation of Index of Cardiac Electrophysiological Balance in Type 1 Diabetes Mellitus. Harran Üniversitesi Tıp Fakültesi Dergisi, 2021, 18(3), 441-5.
Sivri, S.; Çelik, M. Evaluation of index of cardiac-electrophysiological balance before and after hemodialysis in patients with end-stage renal disease. J. Electrocardiol., 2019, 54, 72-75.
Garcion, E.; Wion-Barbot, N.; Montero-Menei, C.N.; Berger, F.; Wion, D. New clues about vitamin D functions in the nervous system. Trends Endocrinol. Metab., 2002, 13(3), 100-105.
[] [PMID: 11893522]
DeLuca, G.C.; Kimball, S.M.; Kolasinski, J.; Ramagopalan, S.V.; Ebers, G.C. Review: The role of vitamin D in nervous system health and disease. Neuropathol. Appl. Neurobiol., 2013, 39(5), 458-484.
[] [PMID: 23336971]
Chen, S.; Swier, V.J.; Boosani, C.S.; Radwan, M.M.; Agrawal, D.K.; Vitamin, D. Deficiency Accelerates Coronary Artery Disease Progression in Swine. Arterioscler. Thromb. Vasc. Biol., 2016, 36(8), 1651-1659.
[] [PMID: 27255724]
Aleksova, A.; Belfiore, R.; Carriere, C.; Kassem, S.; La Carrubba, S.; Barbati, G. Vitamin D deficiency in patients with acute myocardial infarction: An italian single-center study. Int. J Vitam Nutr Res, 2015, 85(1-2), 23-30.
Şeker, T.; Gür, M.; Uçar, H.; Türkoğlu, C.; Baykan, A.O.; Özaltun, B.; Harbalıoğlu, H.; Yüksel Kalkan, G.; Kaypakli, O.; Kuloğlu, O.; Şen, O.; Koç, M.; Çaylı, M. Lower serum 25-hydroxyvitamin D level is associated with impaired myocardial performance and left ventricle hypertrophy in newly diagnosed hypertensive patients. Anatol. J. Cardiol, 2015, 15(9), 744-750.
[] [PMID: 25592096]
Yilmaz, O.; Olgun, H.; Ciftel, M.; Kilic, O.; Kartal, I.; Iskenderoglu, N.Y.; Laloglu, F.; Ceviz, N. Dilated cardiomyopathy secondary to rickets-related hypocalcaemia: Eight case reports and a review of the literature. Cardiol. Young, 2015, 25(2), 261-266.
[] [PMID: 24345686]
Uysal, F.; Ozboyaci, E.; Bostan, O.; Saglam, H.; Semizel, E.; Cil, E. Evaluation of electrocardiographic parameters for early diagnosis of autonomic dysfunction in children and adolescents with type-1 diabetes mellitus. Pediatr. Int., 2014, 56(5), 675-680.
[] [PMID: 24617770]
Tascanov, M.B.; Havlioglu, S.; Tanriverdi, Z.; Gungoren, F.; Altiparmak, İ.H. Effect of noise on the electrocardiographic parameters. Int. Arch. Occup. Environ. Health, 2021, 94(6), 1397-1403.
[] [PMID: 33646333]
Jaroszyński, A.J.; Załuska, W.T.; Książek, A. Effect of haemodialysis on regional and transmural inhomogeneities of the ventricular repolarisation phase. Nephron Clin. Pract., 2005, 99(1), c24-c30.
[] [PMID: 15637460]
Colluoglu, T.; Tanriverdi, Z.; Unal, B.; Ozcan, E.E.; Dursun, H.; Kaya, D. The role of baseline and post-procedural frontal plane QRS -T angles for cardiac risk assessment in patients with acute STEMI. Ann. Noninvasive Electrocardiol., 2018, 23(5), e12558.
[] [PMID: 29873439]
Tascanov, M.B.; Tanriverdi, Z.; Gungoren, F.; Besli, F.; Bicer Yesilay, A.; Altiparmak, H.I.; Bayram, G.; Demir, K. The effect of propofol on frontal QRS-T angle in patients undergoing elective colonoscopy procedure. J. Clin. Pharm. Ther., 2020, 45(1), 185-190.
[] [PMID: 31571255]

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