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1,25-Dihydroxy vitamin D and coronary microvascular function

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The active form of vitamin D (1,25(OH)2D) contributes to blood flow regulation in skeletal muscle. The aim of the present study was to determine whether this hormone also modulates coronary physiology, and thus whether abnormalities in its bioavailability contribute to excess cardiovascular risk in patients with disorders of mineral metabolism.

Methods

As a clinical model of the wide variability in 1,25(OH)2D bioavailability, we studied 23 patients (62 ± 8 years) with suspected primary hyperparathyroidism referred for myocardial perfusion imaging because of atypical chest pain and at least one cardiovascular risk factor. Dipyridamole and baseline myocardial blood flow indexes were assessed on G-SPECT imaging of 99mTc-tetrofosmin, with normalization of the myocardial count rate to the corresponding first-transit counts in the pulmonary artery. Coronary flow reserve (CFR) was defined as the ratio between dipyridamole and baseline myocardial blood flow indexes. In all patients, parathyroid hormone, 25-hydroxy vitamin D (25(OH)D) and 1,25(OH)2D serum levels were determined.

Results

Primary hyperparathyroidism was eventually diagnosed in 15 of the 23 patients. The mean 25(OH)D concentration was relatively low (21 ± 10 ng/mL) while the concentrations of 1,25(OH)2D varied widely but within the normal range (mean 95 ± 61 pmol/L). No patient showed reversible perfusion defects on G-SPECT. CFR was not correlated with either the serum concentration of 25(OH)D nor that of parathyroid hormone, but was strictly correlated with the serum level of 1,25(OH)2D (R = 0.8, p < 0.01). Moreover, patients with a 1,25(OH)2D concentration below the median value (86 pmol/L) had markedly lower CFR than the other patients (1.48 ± 0.40 vs. 2.51 ± 0.63, respectively; p < 0.001).

Conclusion

Bioavailable 1,25(OH)2D modulates coronary microvascular function. This effect might contribute to the high cardiovascular risk of conditions characterized by chronic reduction in bioavailability of this hormone.

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Acknowledgments

The authors are indebted to dr. Paolo Bruzzi for valuable assistance in the statistical analysis. The study was supported by the following public bodies: Italian Ministry of Health (Finanziamento conto capitale 2012) and by Regione Liguria (Finanziamento ricerca sanitaria 2009).

Conflicts of interest

None.

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Authors and Affiliations

  1. Nuclear Medicine, University of Genoa, Genoa, Italy

    Selene Capitanio, Gianmario Sambuceti, Silvia Morbelli, Barbara Repetto, Mehrdad Naseri, Irene Bossert, Maria Teresa Verardi & Michela Massollo

  2. Endocrinology and Internal Medicine, University of Genoa, Genoa, Italy

    Massimo Giusti, Giovanni Murialdo, Lara Vera & Pietro Ameri

  3. Nephrology and Internal Medicine, University of Genoa, Genoa, Italy

    Giacomo Garibotto

  4. Genoa Section, CNR Institute of Molecular Bioimaging and Physiology, Milan, Genoa, Italy

    Cecilia Marini

  5. Nuclear Medicine, Department of Health Science, University of Genoa, IRCCS AOU San Martino – IST Viale Benedetto XV, 6, 16132, Genoa, Italy

    Gianmario Sambuceti

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  1. Selene Capitanio
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Correspondence to Gianmario Sambuceti.

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Capitanio, S., Sambuceti, G., Giusti, M. et al. 1,25-Dihydroxy vitamin D and coronary microvascular function. Eur J Nucl Med Mol Imaging 40, 280–289 (2013). https://doi.org/10.1007/s00259-012-2271-0

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  • DOI: https://doi.org/10.1007/s00259-012-2271-0

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