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Liu Q, Cao K, Li Z, Ye Y, Zhang Q, Zhang H, Xu H, Li Z, Wu Y. Prognostic value of calcium and phosphorus status in elderly heart disease patients with tricuspid regurgitation. Chin Med J (Engl) 2024; 137:613-615. [PMID: 38061989 PMCID: PMC10932521 DOI: 10.1097/cm9.0000000000002916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Indexed: 03/13/2024] Open
Affiliation(s)
- Qingrong Liu
- Department of Cardiology, Beijing Aerospace General Hospital, Beijing 100076, China
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Kai Cao
- Department of Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100000, China
| | - Ziang Li
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Yunqing Ye
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Qian Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Hongliang Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Haiyan Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Zhe Li
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Yongjian Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
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Björkman K, Valkama M, Bruun E, Pätsi P, Kulmala P, Tulppo MP, Leskinen M, Ojaniemi M. Heart Rate and Heart Rate Variability in Healthy Preterm-Born Young Adults and Association with Vitamin D: A Wearable Device Assessment. J Clin Med 2023; 12:7504. [PMID: 38137574 PMCID: PMC10743414 DOI: 10.3390/jcm12247504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/26/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Prematurity has been associated with impaired parasympathetic cardiac regulation later in life. Changes in heart rate (HR) and heart rate variability (HRV) may indicate a risk for future cardiac dysfunction. The putative role of Vitamin D on cardiac autonomic function in individuals born preterm (PT) remains unknown. This study involves monitoring autonomic cardiac regulation and Vitamin D concentrations in 30 PT and 16 full-term (FT) young adults in a free-living context. The PT subjects were born between 1994 and 1997 at Oulu University Hospital. The inclusion criteria were (1) being born ≤ 32 gestation weeks or (2) being born < 34 gestation weeks with a birth weight under 1500 g. Participants wore an Oura ring sleep tracer, a smart ring device, for 2 weeks to monitor cardiac autonomic function. Parameters related to autonomic cardiac regulation, lowest nighttime resting HR, and the root mean square of successive differences (RMSSD) to describe HRV were collected. PT males exhibited a tendency toward lower RMSSD (71.8 ± 22.6) compared to FT males (95.63 ± 29.0; p = 0.10). Female participants had a similar mean RMSSD in the FT and PT groups at 72.04 ± 33.2 and 74.0 ± 35.0, respectively. Serum 25-hydroxyvitamin D concentration did not correlate with cardiac autonomic function parameters. When assessing the lowest resting nighttime HRs and HRVs in a long-term, real-world context, healthy female PT young adults performed similarly to their FT peers. In contrast, the present study's results suggest that male PT young adults exhibit impaired autonomic cardiac function, potentially putting them at risk for cardiovascular disease later in adulthood.
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Affiliation(s)
- Krista Björkman
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
| | - Marita Valkama
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
| | - Ella Bruun
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
| | - Pauli Pätsi
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
| | - Petri Kulmala
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
- Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Mikko P. Tulppo
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, 90014 Oulu, Finland
| | - Markku Leskinen
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
| | - Marja Ojaniemi
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90014 Oulu, Finland;
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Okazaki N, Ikeda H, Honda T, Tsuno K, Inoue F, Takahashi S, Sakurai A, Ueki H, Noguchi Y, Hamada H, Igarashi S. The impact of vitamin D on the onset and progress of Kawasaki disease. Pediatr Int 2022; 64:e15191. [PMID: 35831250 DOI: 10.1111/ped.15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/18/2022] [Accepted: 03/10/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The seasonal epidemic of Kawasaki disease (KD) in winter in Japan suggests that low vitamin D status may affect KD through the immune system. We aimed to evaluate the effect of vitamin D on the onset and clinical course of KD. METHODS We conducted a case-control study to compare 25-hydroxyvitamin D (25(OH)D) levels in KD patients admitted to our hospital between March 2018 and June 2021, with those in healthy controls from published Japanese data. In patients with KD, we evaluated the association of 25(OH)D levels with intravenous immunoglobulin resistance and coronary artery lesions. RESULTS We compared 290 controls and 86 age-group-adjusted patients with KD. The 25(OH)D levels in KD patients were lower than those in the controls (median: 17 vs. 29 ng/mL, P < 0.001). In winter, 25(OH)D levels in KD patients were lower than those in summer (median: 13 vs. 19 ng/mL). The adjusted odds ratios for the onset of KD were 4.9 (95% CI: 2.5-9.6) for vitamin D insufficiency (25(OH)D: 12-20 ng/mL) and 29.4 (95% CI: 12.5-78.2) for vitamin D deficiency (25(OH)D < 12 ng/mL). Among 110 KD patients, 25(OH)D levels at diagnosis of KD were not associated with intravenous immunoglobulin resistance or coronary artery lesions. CONCLUSIONS The 25(OH)D levels in patients with KD were lower than those in the controls, especially in winter. Lower 25(OH)D levels in winter were associated with an increased risk of KD onset. It remains to be elucidated whether the observed association has a causal relationship.
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Affiliation(s)
- Natsumi Okazaki
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Hiroyuki Ikeda
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Takafumi Honda
- Department of Pediatrics, Yachiyo Medical Center, Tokyo Women's Medical University of Medicine, Chiba, Japan
| | - Kazuma Tsuno
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Fumiya Inoue
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Satoko Takahashi
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Ayako Sakurai
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Hideaki Ueki
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Yasushi Noguchi
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Hiromichi Hamada
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shunji Igarashi
- Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan
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The effect of vitamin D3 and thyroid hormones on the capillaroscopy-confirmed microangiopathy in pediatric patients with a suspicion of systemic connective tissue disease-a single-center experience with Raynaud phenomenon. Rheumatol Int 2021; 41:1485-1493. [PMID: 34132891 PMCID: PMC8207495 DOI: 10.1007/s00296-021-04919-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/09/2021] [Indexed: 11/30/2022]
Abstract
Raynaud phenomenon (RP) may be the first manifestation of a systemic connective tissue disease (SCTD). Early detection of dysfunction of small vessels called microangiopathy is essential for the diagnostic process. The focus of this single-center, retrospective study was to investigate the potential dependencies between microvascular image and laboratory markers measured in children with RP. The study analyzed the nail-fold video-capillaroscopy (NVC) findings and laboratory results of 81 children between the ages 6 and 17 who were referred to pediatric rheumatologist with a suspicion of SCTD. Out of 52 patients presenting with RP at the time of evaluation, abnormalities in capillary microscopic imaging were found in 34. NVC findings were then compared to levels of specific biomarkers in serum. Vitamin D3 serum levels have been significantly decreased in patients with RP (23.4 ng/mL ± 8.76 vs. 30.0 ng/mL ± 12.66, P = 0.0148). There were positive significant correlations between levels of vitamin D3 and acute-phase reactants in serum, such as C-reactive protein (P = 0.0292). Furthermore, free thyroxine levels (fT4) in patients with both RP (P = 0.0126) and micro-angiopathy (P = 0.05496) persisted in the lower range of the normal limit (< 1.0 ng/dL). Regular oral supplementation of vitamin D3 should be always considered in children with RP if deficiency is found. Additionally, low fT4 level (< 1.0 ng/dL) should be considered as an indication to perform NVC in patients suspected of SCTD even when they do not present RP.
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Zhang Q, Sun Y, Zhang C, Qi J, Du J. Vitamin D Deficiency and Vasovagal Syncope in Children and Adolescents. Front Pediatr 2021; 9:575923. [PMID: 33732666 PMCID: PMC7959715 DOI: 10.3389/fped.2021.575923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/04/2021] [Indexed: 12/31/2022] Open
Abstract
Aims: To investigate the association of vitamin D deficiency with cardiovascular autonomic nervous system function in children and adolescents with vasovagal syncope (VVS). Methods: This study recruited 76 pediatric patients with VVS and 15 healthy children. The 25-hydroxyvitamin D levels in serum among the participants were evaluated. Heart rate variability analysis including SDNN, rMSSD, and SDANN was tested in patients with VVS. The correlation between indices of time-domain analysis and serum vitamin D status of the children with VVS was investigated. Results: In this work, 25-hydroxyvitamin D levels in serum among VVS cases remarkably decreased compared with those among healthy controls (48.76 ± 19.25 vs. 67.62 ± 15.46 nmol/L, p < 0.01). The vitamin D deficient patients with VVS exhibited a lower rMSDD value compared to the non-deficient group with VVS (45.56 ± 16.87 vs. 61.90 ± 20.38 ms, p < 0.001, respectively). Pearson correlation analysis indicated that serum 25-hydroxyvitamin D levels had positive correlation with rMSDD values (r = 0.466, p < 0.001). Conclusions: As suggested by our data, VVS children and adolescents with vitamin D deficiency may have cardiac autonomic dysfunction and cardiac vagal tone decreases with the reduction in vitamin D level.
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Affiliation(s)
- Qingyou Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yan Sun
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chunyu Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jianguang Qi
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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A double-blind, randomized, placebo- and positive-controlled phase III trial of 1% benvitimod cream in mild-to-moderate plaque psoriasis. Chin Med J (Engl) 2020; 133:2905-2909. [PMID: 33177393 PMCID: PMC7752683 DOI: 10.1097/cm9.0000000000001221] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Benvitimod cream, a novel synthetic small molecule, was effective in treating mild-to-moderate plaque psoriasis. We conducted a phase III clinical trial to assess the efficacy and safety of benvitimod cream in patients with mild-to-moderate plaque psoriasis. Methods We randomly assigned 686 patients (2:1:1) to receive 1% benvitimod cream, 0.005% calcipotriol ointment or placebo twice a day for 12 weeks. The primary efficacy end points were the percentage of patients with a 75% or greater reduction from baseline in the psoriasis area and severity index (PASI 75) score and with a score of 0 or 1 in static physician's global assessment (sPGA) at week 12. Results The results showed that 50.4% of patients in the benvitimod group achieved PASI 75, which was significantly higher than that in the calcipotriol (38.5%, P < 0.05) and placebo (13.9%, P < 0.05) groups. The proportion of patients achieving an sPGA score 0 or 1 was 66.3% in the benvitimod group and 63.9% in the calcipotriol group, which were both significantly higher than that in the placebo group (34%, P < 0.05). In the long-term follow-up study, 50.8% of patients experienced recurrence. After retreatment with 1% benvitimod, 73.3% of patients achieved an sPGA score of 0 or 1 again at week 52. Adverse events included application site irritation, follicular papules, and contact dermatitis. No systemic adverse reactions were reported. Conclusion During this 12-week study, benvitimod cream was demonstrated with high effectiveness and safety in patients with mild-to-moderate plaque psoriasis. Trial Registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR-TRC-13003259; http://www.chictr.org.cn/showprojen.aspx?proj=6300.
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