Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials

Zhao, Jindong; Jia, Jingjing; Dong, Pingshuan; Zhao, Di; Yang, Xinwei; Li, Daolin; Zhang, Huifeng

doi:10.1136/bmjopen-2017-020545

Cited by 36 publications

(27 citation statements)

References 46 publications

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“…A recent meta-analysis of randomized controlled trials (RCTs) on vitamin D supplementation in high-risk cardiovascular patients demonstrated protective effects, improving blood pressure, dyslipidemia, and inflammation [28]. Another meta-analysis that included seven RCTs with a total of 465 patients demonstrated that vitamin D supplementation inhibits ventricular remodeling and improves cardiac function in patients with HF [29]. Additionally, a recent RCT published by Raed et al demonstrated that arterial stiffness was improved by vitamin D supplementation in a dose-dependent manner, in overweight African Americans [30].…”

Section: Discussionmentioning

confidence: 99%

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

et al. 2019

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Background and objectives: The purpose of the study is to correlate vascular calcification biomarkers osteoprotegerin (OPG) and 25-hydroxyvitamin D3 (25-OH-D3), indicators of arterial stiffness carotid-femoral pulse wave velocity (c-f PWV) and renal resistive index (RRI), with parameters of left ventricular function in heart failure patients versus control. Materials and methods: Our case-control study compared 60 patients with ischemic heart failure and reduced left ventricular ejection fraction (LVEF) (<40%) with a control group of 60 healthy age-matched subjects (CON). Serum levels of OPG and 25-OH-D3 were determined by ELISA. Left ventricular volumes (LVESV, LVEDV) and LVEF were measured by echocardiography. C-f PWV was determined using the arteriograph device. RRI was measured by duplex Doppler. Peak systolic velocity (PSV) and minimum end-diastolic velocity (EDV) were determined using angle correction. The estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation. The Pearson’s correlation coefficient was used for interpretation of results. Results: OPG values were significantly higher in heart failure (HF) patients vs. CON (4.7 ± 0.25 vs. 1.3 ± 0.67 ng/mL, p < 0.001). 25-OH vitamin D3 levels were significantly lower in HF patients vs. CON (20.49 ± 7.31 vs. 37.09 ± 4.59 ng/mL, p < 0.001). Multiple regression analysis considering 25-OH D3 as a dependent variable demonstrated indicators of vascular stiffness RRI, c-f PWV and vascular calcification biomarker OPG as predictors. OPG values were significantly correlated with cardiac parameters LVEDV (r = 0.862, p < 0.001), LVEF (r = −0.832, p < 0.001), and c-f PWV(r = 0.833, p < 0.001), and also with 25-OH-D3 (r = −0.636, p < 0.001). RRI values were significantly correlated with cardiac parameters LVEDV (r = 0.586, p < 0.001) and LVEF (r = −0.587, p < 0.001), and with eGFR (r = −0.488, p < 0.001), c-f PWV(r = 0.640, p < 0.001), and 25-OH-D3 (r = −0.732, p < 0.001). Conclusions: This study showed significant correlations between vitamin D deficit and vascular stiffness indicators in heart failure patients with reduced ejection fraction, demonstrating the importance of these examinations for a better evaluation of these patients. Together with the evaluation of renal function, the measurement of vascular stiffness indicators and biomarkers might play a key role in identifying patients at greater risk for worsening disease prognosis and for shorter life expectancy, who could benefit from vitamin D supplementation. The abstract was accepted for presentation at the Congress of the European Society of Cardiology, Munich, 2018.

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Section: Discussionmentioning

confidence: 99%

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

et al. 2019

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“…Echocardiographic measurements of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) are frequently used tools to assess cardiac function and the risk of heart failure. In this regard, available meta-analyses showed inconsistent results with no significant improvement by vitamin D supplementation on LVEF and LVEDD in two analyses [ 76 , 77 ], and a significant dose-dependent increase in LVEF and a decrease in LVEDD in another analysis, suggesting an inhibition of ventricular remodeling [ 78 ] ( Table 2 ). Again, daily doses were substantially higher than the recommended daily dose of 600 to 800 IU/d ( Table 2 ).…”

Section: Data On Vitamin D and Cardiovascular Diseases In Humansmentioning

confidence: 99%

Vitamin D and Cardiovascular Disease: An Updated Narrative Review

Zittermann

Trummer

Theiler‐Schwetz

et al. 2021

IJMS

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During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.

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“…For example, the association between vitamin D deficiency and hypertension was explained by the role of vitamin D in suppressing renin biosynthesis and thus aldosterone secretion, which regulates renal sodium excretion and blood pressure [13]. As well, vitamin D supplementation was able to inhibit ventricular remodeling in patients with heart failure [14] as vitamin D deficiency was associated with oxidative stress, cardiac inflammation, fibrosis and apoptosis [15]. Moreover, sufficient vitamin D levels may reduce atherosclerosis by decreasing macrophage cholesterol uptake and formation of foam cells [16].…”

Section: Introductionmentioning

confidence: 99%

Association of 25-hydroxyvitamin D with HDL-cholesterol and other cardiovascular risk biomarkers in subjects with non-cardiac chest pain

2019

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Background: Chest pain is a serious symptom that is routinely investigated as a sign of coronary artery disease. Non-cardiac chest pain (NCCP) is indistinguishable from ischemic chest pain and both are considered serious and receive similar medical investigations. Although NCCP is not associated with cardiovascular diseases (CVDs), patients with NCCP may become anxious and frightened from developing coronary events. So, it will be valuable to improve modifiable cardiovascular risk factors in such subjects to reduce fear from CVDs. Because vitamin D deficiency was considered as a possible modifiable cardiovascular risk factor, our aim was to investigate association between serum vitamin D and cardiovascular risk variables in subjects with NCCP. Methods: A cross-sectional study involved 104 subjects who underwent cardiac catheterization that did not reveal any cardiac origin for their chest pain. 25-hydroxyvitamin D was measured by electrochemiluminescence immunoassay, glucose was measured by hexokinase method, hemoglobin A1c (HbA1c) was measured by turbidimetric inhibition immunoassay and lipid profile was measured by enzymatic colorimetric assays. Results: High density lipoprotein cholesterol (HDL-C) was significantly higher in subjects with sufficient vitamin D compared to those with insufficient or deficient vitamin D (p-value< 0.01). 25-hydroxyvitamin D was positively associated with HDL-C (p-value< 0.01) and inversely associated with HbA1c (p-value = 0.02). 25-hydroxyvitamin D was not significantly correlated with other cardiovascular biomarkers including blood pressure, glucose, and other components of lipid profile (p-values> 0.05). Conclusions: low serum vitamin D could be involved in reducing HDL-C and increasing HbA1c and thus it may increase cardiovascular risk in subjects with NCCP.

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Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials

Cited by 36 publications

References 46 publications

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

Vitamin D and Cardiovascular Disease: An Updated Narrative Review

Association of 25-hydroxyvitamin D with HDL-cholesterol and other cardiovascular risk biomarkers in subjects with non-cardiac chest pain

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