Vitamin D supplementation of 4000 IU daily and cardiac function in patients with advanced heart failure: The EVITA trial

• Published in: International journal of cardiology 2019-04, Vol.280, p.117-123
• Main Authors: Zittermann, A., Ernst, J.B., Prokop, S., Fuchs, U., Gruszka, A., Dreier, J., Kuhn, J., Knabbe, C., Berthold, H.K., Gouni-Berthold, I., Pilz, S., Gummert, J.F., Paluszkiewicz, L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Dietary Supplements; Drug Administration Schedule; Echocardiography; Female; Follow-Up Studies; Heart failure; Heart Failure - diagnostic imaging; Heart Failure - drug therapy; Heart Failure - physiopathology; Humans; Left ventricular ejection fraction; Male; Middle Aged; Randomized controlled trial; Ventricular Function, Left - drug effects; Ventricular Function, Left - physiology; Vitamin D; Vitamin D - administration & dosage
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2019.01.027

Data regarding the effects of vitamin D on cardiac function are inconclusive. In a post-hoc analysis of the EVITA (Effect of vitamin D on mortality in heart failure) trial, we investigated whether a daily vitamin D3 supplement of 4000 IU for three years affects echocardiography parameters like left ventricular end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), and LV ejection fraction (LVEF) in patients with advanced heart failure (HF) and 25‑hydroxyvitamin D levels  0.05). However, in the subgroup of patients aged ≥50 years, vitamin D treatment was associated with an increase in LVEF of 2.73% (95%CI: 0.14 to 5.31%) at 12 months post-randomization (n = 311). The increase was slightly attenuated to 2.60% (95%CI: −2.47 to 7.67%) at 36 months post-randomization (n = 242). Our data indicate that vitamin D supplementation does not significantly improve cardiac function in all patients with advanced HF. However, vitamin D probably improves LV function in HF patients aged ≥50 years. •The effect of vitamin D on cardiac function is hotly debated but available data are inconclusive.•We investigated the effect of a daily vitamin D3 supplement of 4,000 IU for three years on cardiac function.•Vitamin D supplementation may not improve cardiac function in all patients with heart failure, but probably in patients aged ≥ 50 years.