The role of vitamin d supplementation in patients with heart failure. a randomized double blind controlled trial

Objective: Low vitamin D levels are commonly founded in patients with heart failure and may contribute to worsen the heart function. We examined the influence of vitamin D supplementation on left ventricular ejetion fraction (EF%) in patients with deficiency. Design and methods: We randomized twenty-three chronic heart failure patients in parallel group, double bind, placebo-controlled trial. All patients mean age 74 years, and with vitamin D levels <30 ng/mL, received 800.000 U of oral cholecalciferol or placebo during the six months follow-up. Outcomes measured at baseline and after 6 months were EF% and other echocardiography parameters (left ventricular mass, wall thickness, end-diastolic and systolic diameter), natriuretic peptides, lipid profile, renin, anti-inflammatory cytokines, PTH, blood pressure and BMI. Results: In patients in active treatment mean plasma vitamin D concentrations after 6months significantly increased with the respect of the placebo group (active treatment +15.51 ng/mL [CI 10,4-20,6], placebo group -1.40 ng/mL [CI -8,15 – 5,35], p<0.001). Other bone biomarkers (Calcium and Parathyroid hormone) did not differ between the two groups after 6 months. At the end of the follow-up period, EF significantly increased in the intervention group as compared to the placebo group (active treatment + 6.71% [CI 0,8-12,6 ] while placebo group -4.3% [CI -9,5 – 0,9]; p =0.007). No any significant variations have been seen on cytokines levels, B-type natriuretic peptides levels, renin levels, blood pressure, lipid profile and BMI. Conclusions: Six months of Vitamin D supplementation significantly improves ejection fraction in elderly patients with heart failure and vitamin D deficiency.