Effect of vitamin D on endothelial and ventricular function in chronic heart failure patients: A prospective, randomized, placebo-controlled trial
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Key result
Vitamin D3 supplementation at 4000 IU daily for 6 months did not improve endothelial function compared to placebo in patients with chronic heart failure, although it did improve 6-minute walk distance and left atrial diameter.
Why the study?
Low 25-hydroxyvitamin D levels are common in chronic heart failure and linked to increased mortality, but the safety, efficacy, and effects of oral vitamin D3 supplementation on endothelial and ventricular function remained unclear.
Does vitamin D3 supplementation improve endothelial function in patients with stable chronic heart failure and vitamin D deficiency?
Comparison
4000 IU vitamin D daily vs placebo
Design
Multicenter prospective randomized placebo-controlled trial
Follow-up
6 months
Authors
Discussion
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Implication
4000 IU daily vitamin D3 appears safe in stable HF; extends evidence for ventricular but not endothelial effects.
Study Design
Type
RCT (n=73)
Blinding
Double-blind
Randomization
1:1 ratio
Multicenter
Yes
Structured PICO
Does vitamin D3 supplementation improve endothelial function in patients with stable chronic heart failure and vitamin D deficiency?
P
Population
73 patients with stable chronic heart failure and vitamin D deficiency on optimal medical therapy, randomized to vitamin D or placebo and followed for 6 months.
I
Intervention
Vitamin D3 (cholecalciferol) 4000 IU oral once daily for 6 months.
C
Comparator
Matching placebo (1 tablet of placebo of vitamin D3) once daily for 6 months.
O
Outcome
Change in endothelial function between baseline and after 6 months as assessed using EndoPAT.surrogate
Main Result
p-value: p=0.47
High-dose vitamin D supplementation in stable heart failure patients with vitamin D deficiency does not improve endothelial function or left ventricular remodeling, but may improve symptoms, exercise capacity, and left atrial diameter.
Limitations
- Small number of patients
- Relatively short follow-up period
- Heterogeneous etiology of heart failure
- No central blood pressure monitoring to consider seasonal variation in vitamin D
- Did not assay other biomarkers related to vitamin D metabolism or sex hormones
- Did not examine the effect in patients with chronic heart failure and preserved ejection fraction
- Short study duration
- Less remodeled LV patient population
Cite This Study
Woo et al. (2022) conducted an RCT in chronic heart failure (n=73). Vitamin D3 (cholecalciferol) vs. Placebo was evaluated on Difference in endothelial function assessed by pulse amplitude tonometry (EndoPAT) from baseline to 6 months (p=0.47). Vitamin D3 supplementation at 4000 IU daily for 6 months did not improve endothelial function compared to placebo in patients with chronic heart failure, although it did improve 6-minute walk distance and left atrial diameter.
Topics
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