Major impact of vitamin D3 deficiency and supplementation on left ventricular torsional mechanics during dobutamine stress in uncomplicated type 2 diabetes

Philippe Obert; Stéphane Nottin; Clothilde Philouze; Falah Aboukhoudir

doi:10.1016/j.numecd.2023.06.017

Major impact of vitamin D₃ deficiency and supplementation on left ventricular torsional mechanics during dobutamine stress in uncomplicated type 2 diabetes

Nutr Metab Cardiovasc Dis. 2023 Nov;33(11):2269-2279. doi: 10.1016/j.numecd.2023.06.017. Epub 2023 Jun 24.

Authors

Philippe Obert¹, Stéphane Nottin², Clothilde Philouze², Falah Aboukhoudir³

Affiliations

¹ UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France. Electronic address: philippe.obert@univ-avignon.fr.
² UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France.
³ UPR(4278) LaPEC, Laboratory of Experimental Cardiovascular Physiology, Avignon University, Avignon, France; Cardiology department, Duffaut Hospital Center, Avignon, France. Electronic address: faboukhoudir@ch-avignon.fr.

PMID: 37543521
DOI: 10.1016/j.numecd.2023.06.017

Abstract

Background and aims: Hypovitaminosis D is associated with the risk of diabetic complications. Its role in diabetic-related cardiac abnormalities remain poorly understood. We aimed therefore to evaluate the effect of vitamin D deficiency and supplementation on early left ventricular (LV) dysfunction in vitamin D deficient patients with uncomplicated T2D.

Methods and results: Sixty-three consecutive T2D patients who had a diagnosis of vitamin D₃ were prospectively recruited and allocated into 2 groups (25(OH)D < 20 ng/mL: VD_D, >20 ng/mL VD_ND). Twenty-eight of them with 25(OH)D < 20 ng/mL benefited from a 3-month supplementation. At baseline and follow-up, after conventional echocardiography including evaluation of epicardial adipose tissue (EAT), both LV longitudinal (LS) and circumferential (CS) strains and rotation/twist mechanics were evaluated at rest and during dobutamine (DOB) stress. After treatment, T2D patients successfully normalized their 25(OH)D levels. The strongest associations between vitamin D deficiency and supplementation with LV myocardial function were noticed for torsional mechanics indexes under DOB. EAT correlated significantly (p < 0.01) with baseline 25(OH)D and was reduced after supplementation. Significant correlations were obtained between these 2 parameters with twist or apical rotation at baseline (p < 0.01) and between their delta changes at follow-up (p < 0.01) under DOB. Significant improvements in LS and CS (p < 0.05) under DOB were also underlined at follow-up, with major enhancements noticed in the apical region (p < 0.01) of the LV.

Conclusions: This study provides the first evidences of the potential of vitamin D supplementation as an efficient prophylactic strategy to alleviate the progression of myocardial dysfunction in asymptomatic patients with uncomplicated T2D.

Clinicaltrials: NCT03437421.

Keywords: Dobutamine stress echocardiography; Regional myocardial function; Speckle-tracking imaging; Uncomplicated type 2 diabetes; Vitamin D(3).

Associated data

ClinicalTrials.gov/NCT03437421