Effects of Vitamin D on Cardiac Function in Patients With Chronic HF

Witte, Klaus K.; Byrom, Rowena; Gierula, John; Paton, Maria F.; Jamil, Haqeel A.; Lowry, Judith E.; Gillott, Richard G.; Barnes, Sally A.; Chumun, Hemant; Kearney, Lorraine C.; Greenwood, John P.; Plein, Sven; Law, Graham R.; Pavitt, Sue; Barth, Julian H.; Cubbon, Richard M.; Kearney, Mark T.

doi:10.1016/j.jacc.2016.03.508

Cited by 229Vitamin D Research StudiesHeart Failure Treatment and ManagementCardiovascular Function and Risk Factors

Effects of Vitamin D on Cardiac Function in Patients With Chronic HF

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Witte, Klaus K., Byrom, Rowena, Gierula, John, Paton, Maria F., Jamil, Haqeel A., Lowry, Judith E., Gillott, Richard G., Barnes, Sally A. +9 more·2016·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2016.03.508PMC PMC4893154

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Abstract

BACKGROUND: Patients with chronic heart failure (HF) secondary to left ventricular systolic dysfunction (LVSD) are frequently deficient in vitamin D. Low vitamin D levels are associated with a worse prognosis. OBJECTIVES: The VINDICATE (VitamIN D treatIng patients with Chronic heArT failurE) study was undertaken to establish safety and efficacy of high-dose 25 (OH) vitamin D3 (cholecalciferol) supplementation in patients with chronic HF due to LVSD. METHODS: We enrolled 229 patients (179 men) with chronic HF due to LVSD and vitamin D deficiency (cholecalciferol <50 nmol/l [<20 ng/ml]). Participants were allocated to 1 year of vitamin D3 supplementation (4,000 IU [100 μg] daily) or matching non-calcium-based placebo. The primary endpoint was change in 6-minute walk distance between baseline and 12 months. Secondary endpoints included change in LV ejection fraction at 1 year, and safety measures of renal function and serum calcium concentration assessed every 3 months. RESULTS: One year of high-dose vitamin D3 supplementation did not improve 6-min walk distance at 1 year, but was associated with a significant improvement in cardiac function (LV ejection fraction +6.07% [95% confidence interval (CI): 3.20 to 8.95; p < 0.0001]); and a reversal of LV remodeling (LV end diastolic diameter -2.49 mm [95% CI: -4.09 to -0.90; p = 0.002] and LV end systolic diameter -2.09 mm [95% CI: -4.11 to -0.06 p = 0.043]). CONCLUSIONS: One year of 100 μg daily vitamin D3 supplementation does not improve 6-min walk distance but has beneficial effects on LV structure and function in patients on contemporary optimal medical therapy. Further studies are necessary to determine whether these translate to improvements in outcomes. (VitamIN D Treating patIents With Chronic heArT failurE [VINDICATE]; NCT01619891).

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The low sensitivity of NYHA classification and 6 min walk test limits their ability to measure change over time.
“The low sensitivity of NYHA classification and 6 min walk test limits their ability to measure change over time”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [38]
The Discussion (page not provided) says six-minute walk distance had greater variability than expected, leaving the trial underpowered to detect a clinically relevant change. This supports a limitation of the 6-minute walk test in detecting change in this trial. The Results list baseline NYHA classes but do not assess the classification’s sensitivity to change over time. (LLM, conf=0.85)
Experimental — accuracy not yet measured
The additional equipment to measure metabolic gas exchange limits the widespread applicability of cardiopulmonary exercise testing.
“while the additional equipment to measure metabolic gas exchange limits the widespread applicability of cardiopulmonary exercise testing. 38 , 39”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [38]
The Methods > Study procedures section describes a six-minute walk test, echocardiography, and cardiac MRI, but not cardiopulmonary exercise testing. Searches for metabolic gas exchange equipment and limits on the applicability of cardiopulmonary exercise testing found no passage addressing the claim. Page numbers are unavailable in our copy. (LLM, conf=0.75)
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Authors: Witte, K. K., Byrom, R., Gierula, J., Paton, M. F., Jamil, H. A., Lowry, J. E., Gillott, R. G., Barnes, S. A., Chumun, H., Kearney, L. C., Greenwood, J. P., Plein, S., Law, G. R., Pavitt, S., Barth, J. H., Cubbon, R. M., & Kearney, M. T.
Affiliations: University of Leeds (GB)
Leeds Teaching Hospitals NHS Trust (GB)
Corresponding author: Witte, Klaus K.
ORCID: Witte, Klaus K.
Gierula, John
Paton, Maria F.
Jamil, Haqeel A.
Lowry, Judith E.
Greenwood, John P.
Plein, Sven
Law, Graham R.
Pavitt, Sue
Barth, Julian H.
Cubbon, Richard M.
Kearney, Mark T.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2016-06
Volume: 67
Issue: 22
Pages: 2593-2603
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2016.03.508
PMC: PMC4893154
OpenAlex: W2338797564
Cited by: 229
References: 45
Citations by year: 2026: 7 · 2025: 10 · 2024: 18 · 2023: 23 · 2022: 21 · 2021: 23 · 2020: 26 · 2019: 22 · 2018: 34 · 2017: 30 · 2016: 14 · 2013: 1
FWCI: 30.30
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Journal of the American College of Cardiology (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Lincoln Repository (University of Lincoln) (acceptedVersion)
White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Figshare (submittedVersion, cc-by)
Funders: National Institute for Health and Care Research (HCS DRF-2014-05-006)
British Heart Foundation (RG/09/010/28087, FS/12/80/29821, FS/10/028/28252)
University of Leeds
National Institutes of Health
Medical Research Council (MR/J00281X/1)
Topics: Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: vitamin D supplementation, chronic heart failure, left ventricular systolic dysfunction, vitamin D deficiency, 25-hydroxyvitamin D3, vitamin D3, left ventricular ejection fraction, left ventricular remodeling, 6-minute walk distance, renal function, serum calcium
MeSH terms: Walk Test, Aged, Calcifediol, Calcitriol, Cholecalciferol, Double-Blind Method, Echocardiography, Female, Heart Failure, Heart Ventricles, Humans, Male, Middle Aged, Stroke Volume, Systole, Vitamins, Ventricular Dysfunction, Left, Magnetic Resonance Imaging, Cine, Ventricular Remodeling

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Effects of Vitamin D on Cardiac Function in Patients With Chronic HF

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