Evaluation of the relationship between vitamin D level and structural and dynamic parameters of echocardiographic right and left heart in sports players

Athlete's heart, is a non-pathological condition commonly seen in sports medicine practice in which the heart is enlarged to allow increased maximal stoke volume, and the resting heart rate is lower than normal. The relationship between the type of sports and changes in systolic function, diastolic function, and especially the determinants of these changes, such as vitamin D and other biochemical markers, has not been well established. This study aimed to investigate the systolic and diastolic properties of athlete's heart as assessed by conventional two-dimensional echocardiographic (2D) and Doppler parameters in athletes involved in different sports disciplines. Ninety-three athletes between 18-40 years of age with no history of chronic disease who admitted to Hacettepe University Department of Sports Medicine were included to this study. Data including age, height, weight, International Physical Activity Questionnaire (IPAQ) scores, serum vitamin D values and some biochemical marker values of the participants were recorded. In addition, all individuals completed a questionnaire that included exposure time to daily sunlight, type of skin exposure, and use of sunscreen. The patient data recorded for evaluation included the findings from echocardiography and electrocardiography. Football players and runners had higher vitamin D values than weightlifters and control group. (25.1 ng/mL, 24.9 ng/mL, 18.9 ng/mL, 22.2 ng/mL, respectively). Runners had significantly higher mean ECG (Electrocardiography) Cornell values than control group (13,36 ± 4,77 vs 8,50 ± 4,27 mV, p=0.005). Football players, weihtlifters and running subgroups had greater left ventricular mass index compared with the control group (83.7 ± 14.7, 75.7 ± 12.3, 84.2 ± 15.8, 69.9 ± 15.0 ng/mL, respectively, p=0.002). There was no statistically significant difference between groups in the diastolic echocardiographic values according to their vitamin D status. The frequency of false tendons in the left ventricle appears to be higher in football players, weighlifters and runners than in the control group (26.3%, 18.2%, 4.6% vs 12%, respectively). Football players, runners and weightlifters had remodeling of left ventricular structures. However, there is less evidence of enhanced diastolic function in endurance athletes compared to controls. Besides, our results suggest that the cardiac diastolic function was not affected by vitamin D deficiency in athletes.