Impact of Vitamin D Supplementation in a Heart Failure Population
DOI:
https://doi.org/10.24950/rspmi.o.224.4.2021Keywords:
Heart Failure; Vitamin D; Vitamin D DeficiencyAbstract
Introduction: Vitamin D (VD) deficiency is a major comorbidity, frequently associated to heart failure (HF). VD supplementation effects in these patients remain unknown. Therefore, this study aims to evaluate the impact of VD deficiency treatment or therapy correction in HF patients´ cohort.
Material and Methods: Observational retrospective single-center study enrolling patients admitted to a HF clinic with VD deficiency. VD was prescribed to these patients with reassessment of its levels 12 months later. Study population was divided in: [VD (+) group: corrected VD deficiency] and [VD (-): maintained VD deficiency]. Variables were analysed in both groups.
Results and Conclusion: Eighty-seven patients were included with no difference of baseline characteristics between the groups. Poor compliance was reported in 40% of VD (-) patients. After treatment, there were no statistically difference in variables analysed between the two groups: NYHA class I, NT-proBNP, HF hospitalizations in the previous year, Duke Activity Score Index score and 6-minute Walking Distance. VD (+) group had a statistically significant decrease of NT-proBNP level over time (1740 ± 2761 pg/mL to 851 ± 1436 pg/mL, p = 0.001). Statistically, both groups had a significant reduction of the number of HF hospitalizations, between baseline and 12 months later (1.02 ± 0.67 to 0.29 ± 0.82, p< 0.001 and 1.03 ± 1.04 to 0.40 ± 0.81, p = 0.001, for VD (+) and VD (-), respectively). Therefore, the correction of VD deficiency did not have impact in the variables analysed. The improvements reported within both groups may reflect the impact of the HF clinic optimized care.
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Brinkley D, Ali O, Zalawadiya S, Wang T. Vitamin D and Heart Failure. Curr Heart Fail Rep. 2017;14:410-20. doi: 10.1007/s11897-017-0355-7.
Porto C, Silva V, Luz J, Filho B, Silveira V. Association between vitamin D deficiency and heart failure risk in the elderly. ESC Heart Failure. 2018;5:63-74. doi:10.1002/ehf2.12198
Costanzo S, Curtis A, Castelnuovo A, Persichillo M, Bonaccio M, Pounis G, et al. Serum vitamin D deficiency and risk of hospitalization for heart failure: Prospective results from the Moli-sani study. Nutr Metab Cardiovasc Dis. 2017;28:1-10. doi: 10.1016/j.numecd.2017.11.008
Song E, Wu J. Associations of vitamin D intake and sleep quality with cognitive dysfunction in older adults with heart failure. Eur J Cardiovasc Nurs. 2018;33:1-7. doi: 10.1097/JCN.0000000000000469.
Song E, Wu J, Moser D, Kang S, Lennie T. Vitamin D supplements reduce depressive symptoms and cardiac events in heart failure patients with moderate to severe depressive symptoms. Eur J Cardiovasc Nurs. 2017;17:1-10. doi:10.1177/1474515117727741.
Jiang W, Gu H, Zhang Y, Xia Q, Qi J, Chen J. Vitamin D Supplementation in the Treatment of Chronic Heart Failure: A Meta-analysis of Randomized Controlled Trials. Clin Cardiol. 2016;39:56-61. doi: 10.1002/clc.22473.
Zittermann A, Ernst J, Prokop S, Fuchs U, Dreier J, Kuhn J, et al. Vitamin D supplementation and bone turnover in advanced heart failure: the EVITA trial. Osteoporos Int. 2018;29:579-86. doi: 10.1007/s00198-017-4312-9.
Huang W, Yang J, Yang J, Wang H, Yang C, Yang Y. Vitamin D and new-onset atril fibrillation: A meta-analysis of randomized controlled trials. Hell J Cardiol. 2018;59:72-7. doi.org/10.1016/j.hjc.2017.11.006
Rodriguez A, Mousa A, Ebeling P, Scott D, Courten B. Effects of vitamin D supplementation on inflammatory markers in heart failure: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2018;8:1-8. doi: 10.1038/s41598-018-19708-0.
Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83:754-9. doi: 10.1093/ajcn/83.4.754.
Witte KK, Byrom R, Gierula J, Paton MF, Jamil HA, Lowry JE, et al. Effects of Vitamin D on Cardiac Function in Patients With Chronic HF: The VINDICATE Study. J Am Coll Cardiol. 2016;67:2593–603. doi: 10.1016/j.jacc.2016.03.508.
Pilz S, März W, Wellnitz B, Seelhorst U, Fahrleitner-Pammer A, Dimai H, et al. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrinol Metab. 2008;93:3927–35. doi: 10.1210/jc.2008-0784
Caraballo C, Desai N, Mulder H, Alhanti B, Wilson P, Fiuzat M et al. Clinical Implications of the New York Heart Association Classification. J Am Heart Assoc. 2019;8:e014240. doi: 10.1161/JAHA.119.014240
Berger R, Huelsman M, Strecker K, Bojic A, Moser P, Stanek B et al. B-type natriuretic peptide predicts sudden death in patients with chronic heart failure. Circulation. 2002;105:2392. doi:10.1161/01.cir.0000016642.15031.34.
Tsutamoto T, Wada A, Maeda K, Hisanaga T, Maeda Y, Fukai D et al. Attenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure: prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction. Circulation. 1997;96:509.doi: 10.1161/01.cir.96.2.509.
Tsutamoto T, Wada A, Maeda K, Hisanaga T, Mabuchi N, Hayashi M et al. Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. Comparison with plasma angiotensin II and endothelin-1. Eur Heart J. 1999;20:1799. doi: 10.1053/euhj.1999.1746.
Zhao J, Jia J, Dong P, Zhao D, Yang X, Li D, et al. Effect of Vitamin D on ventricular remodelling in heart failure: a meta analysis of randomised controlled trials. BMJ Open. 2018;8:1-10. doi:10.1136/ bmjopen-2017-020545
Cubbon R, Lowry J, Drozd M, Hall M, Gierula J, Paton M, et al. Vitamin D deficiency is an independent predictor of mortality in patients with chronic heart failure. Eur J Nutr. 2019;58:2535-43. https://doi.org/10.1007/s00394-018-1806-y
Marra A, Salzano A, Arcopinto M, Piccioli L, Raparelli V. The impact of gender in cardiovascular medicine: Lessons from the gender/sex-issue in heart failure. Monaldi Arch Chest Dis. 2018,88:48-52. doi: 10.4081/monaldi.2018.988
Djoussé L, Cook N, Kim E, Bodar V, Walter J, Bubes V et al. Supplementation with Vitamin D and Omega-3 Fatty Acids and Incidence of Heart Failure Hospitalization. Circulation. 2020;141:784-6. doi:10.1161/CIRCULATIONAHA.119044645
Shah MR,Hasselblad V,Gheorghiade M, Adams Jr K, Swedberg K, Califf R, et al. Prognostic usefulness of the six-minute walk in patients with advanced congestive heart failure secondary to ischemic or nonischemic cardiomyopathy. Am J Cardiol. 2001;88:987-93. https://doi.org/10.1016/S0002-9149(01)01975-0
Arslan S, Erol M, Gundogdu F, Sevimli S, Aksakal E, Senocak H, et al. Prognostic Value of 6-Minute Walk Test in Stable Outpatients with Heart Failure. Tex Heart Inst J. 2007;34:166-9
Grodin J, Hammadah M, Fan Y, Hazen S, Tang W. Prognostic Value of Estimating Functional Capacity Using the Duke Activity Status Index in Stable Patients with Chronic Heart Failure. J Card Fail. 2015,21:44–50. doi:10.1016/j.cardfail.2014.08.013.
Boer RA, Meems LM, Veldhuisen. Vitamin D supplementation in heart failure: case closed? Eur J Heart Fail. 2017;38:2287-9. doi: 10.1093/eurheartj/ehx341.
Latic N and Erben R. Vitamin D and cardiovascular disease, with emphasis on hypertension, atherosclerosis, and heart failure. Int J Mol Sci. 2020;21,6483. doi: 10.3390/ijms21186483
Naghedi A, Haghaninejad H, Varastehravan H, Naghedi A, Farshadi N. Effects of vitamin D supplements on left ventricular ejection fraction in patients with heart failure: A systemic review and meta-analysis of randomized controlled trials. Rev Port Cardiol. 2021;40:447-55. doi: 10.1016/j.repc.2020.10.014
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