Patophysiological basis of folate cycle disorders and vitamin D deficiency in the development of syncope in childhood

Abstract

There are many reports about the role of vitamins B6, B9, B12, and D in the development of cardiovascular diseases. However, most of them relate mainly to the adult population and are limited relative to grades in children with syncope. Understanding the role of these vitamins in the pathogenesis of syncope will help expand the range of therapeutic and preventive care for children. The purpose of the study was to analyse current scientific achievements regarding the role of the folate cycle and vitamin D in the genesis of syncope in childhood. The PubMed Medline and Scopus databases were used and the following search terms were used: “syncope” and “vitamin B”; “syncope” and “homocysteine”; “syncope” and “vitamin D”. The paper summarises the role of vitamin B12 deficiency in delayed myelination and nerve conduction, increased serum norepinephrine levels, and possible pathogenetic mechanisms for the development of noncardiogenic syncope. Scientific facts of the effect of vitamins B1, B6, and B9 on the functioning of the cardiovascular and nervous systems in children are described. The prevalence of vitamin D deficiency in 60-73% of children with vasovagal syncope and its relationship with the symptoms of the disease was established. Probable pathogenetic mechanisms of vitamin D deficiency in the development of syncope, namely a decrease in peripheral vascular resistance, a violation of neuronal conduction of the baroreflective mechanism, and heart muscle dysfunction, are analysed. The findings will allow doctors and researchers to better approach the diagnosis, prevention, and treatment of syncope in childhood and can serve as a basis for developing new strategies to manage the condition and improve medical practices