The effect of vitamin D levels on clinical outcomes after pediatric open-heart surgery

Document Type : original articles

Authors

1 Department of Professional Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Student Research Committee. Fasa University of Medical Sciences, Fasa, Iran

4 Department of Professional Health, Shiraz University of Medical Science, Shiraz, Iran

Abstract

Objectives: Congenital heart disease is a massive structural abnormality in the heart or large vessels inside the chest that is potentially important. Vitamin D is essential for the recovery of organs. This study aimed to evaluate the effect of serum vitamin D levels on clinical outcomes after pediatric open-heart surgery. Recent studies in infants have shown that vitamin D deficiency and hypocalcemia are associated with heart shock.
 
Methods: The following descriptive cross-sectional study was conducted in the Cardiology Unit of Shahid Faghihi Hospital in Shiraz from April 2021 to October 2022, involving 115 patients aged one to seven years old. Serum levels of vitamin D were measured to evaluate the correlation between vitamin D levels and postoperative clinical outcomes. Data was gathered using SPSS.v16 software and analyzed through statistical tests.
 
Results: The mean age of the patients in this study was 29.20± 53.10 months. The average vitamin D level of the patients was 24.52± 10.3 ng/ml. The study's findings indicated that infants eligible for heart surgery with normal vitamin D levels had significantly shorter durations of Inotropes, ventilators, chest tubes, and Intensive Care Unit (ICU) stay (P<0.001).
 
Conclusions: Decreased vitamin D levels in children with abnormal vitamin D can delay the improvement of heart and myocardial function and increase the use of inotropes, ventilators, and chest tubes. It also increases the number of days hospitalized in the ICU after Cardio Pulmonary Bypass (CPB) surgery.

Keywords


1.Koster MPH, van Duijn L, Krul-Poel YHM, et al. A compromised maternal vitamin D status is associated with congenital heart defects in offspring. Early Hum Dev. 2018;117:50-56.
2.Rodriguez AJ, Mousa A, Ebeling PR, et al. Effects of vitamin D supplementation on inflammatory markers in heart failure: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2018;8(1):1169.
3.Mokhtar WA, Fawzy A, Allam RM, et al. Maternal vitamin D level and vitamin D receptor gene polymorphism as a risk factor for congenital heart diseases in offspring; An Egyptian case-control study. Genes  Dis. 2018;6(2):193-200.
4.Dodge-Khatami J, Adebo DA. Evaluation of complex congenital heart disease in infants using low dose cardiac computed tomography. Int J Cardiovasc Imaging. 2021;37(4):1455-1460.
5.McNally JD, O’Hearn K, Lawson ML, et al. Prevention of vitamin D deficiency in children following cardiac surgery: study protocol for a randomized controlled trial. Trials. 2015;16:402.
6.Shedeed SA. Vitamin D supplementation in infants with chronic congestive heart failure. Pediatr cardiol. 2012;33(5):713-9.
7.Dohain AM, Almogati J, Al-Radi OO, et al. Serum vitamin D status following pediatric cardiac surgery and association with clinical outcome. Eur J Pediatr. 2020;179(4):635-643.
8.Acharya P, Dalia T, Ranka S, et al. The effects of vitamin D supplementation and 25-hydroxyvitamin D levels on the risk of myocardial infarction and mortality. J Endocr Soc. 2021;5(10):bvab124.
9.Turin A, Bax JJ, Doukas D, et al. Interactions among vitamin D, atrial fibrillation, and the renin-angiotensin-aldosterone system. Am J Cardiol. 2018;122(5):780-784.
10.Hiemstra TF, Lim K, Thadhani R, et al. Vitamin D and atherosclerotic cardiovascular disease. J Clin Endocrinol Metab. 2019;104(9):4033-4050.
11.Wang T, Liu Z, Fu J, et al. Meta-analysis of vitamin D supplementation in the treatment of chronic heart failure. Scand Cardiovasc J. 2019;53(3):110-116.
12.Kheiri B, Abdalla A, Osman M, et al. Vitamin D deficiency and risk of cardiovascular diseases: a narrative review. Clin Hypertens. 2018;24:9.
13.Ebenezer K, Job V, Antonisamy B, et al. Serum vitamin D status and outcome among critically ill children admitted to the pediatric intensive care unit in South India. Indian J Pediatr. 2016;83(2):120-5.
14.Abou Zahr R, Faustino EVS, Carpenter T, et al. Vitamin D status after cardiopulmonary bypass in children with congenital heart disease. J Intensive Care Med. 2017;32(8):508-513.
15.Tasdighi E, Hekmat M, Beheshti M, et al. Vitamin D treatment attenuates heart apoptosis after coronary artery bypass surgery: a double-blind, randomized, placebo-controlled clinical trial. J Cardiovasc Pharmacol Ther.  2020;25(4):338-345.
16.Kendrick J, Targher G, Smits G, et al. 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey. Atherosclerosis. 2009;205(1):255-60.
17.Kim DH, Sabour S, Sagar UN, et al. Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol. 2008; 102(11):1540-4.
Volume 3, Issue 2
December 2023
Pages 13-17
  • Receive Date: 03 January 2024
  • Revise Date: 12 March 2024
  • Accept Date: 12 March 2024
  • First Publish Date: 12 March 2024