Vitamin D deficiency and clinical outcome in patients with chronic heart failure: A review

Nutr Metab Cardiovasc Dis. 2017 Oct;27(10):837-849. doi: 10.1016/j.numecd.2017.07.009. Epub 2017 Jul 29.

Abstract

Aim: The aim of this review was to summarize evidence on the role of Vitamin D deficiency in heart failure (HF), from pathophysiological mechanisms to clinical effects of Vitamin D supplementation.

Data synthesis: Chronic HF secondary to left ventricular (LV) systolic dysfunction is a growing health problem, still associated with poor clinical outcome. In recent years, experimental and epidemiological evidence focused on the role of Vitamin D in HF. Cross sectional studies demonstrated that prevalence of HF is increased in patients with Vitamin D deficiency or parathyroid hormone (PTH) plasma level increase, whereas longitudinal studies showed enhanced risk of developing new HF in patients with Vitamin D deficiency. In addition, in patients with established HF, low plasma levels of Vitamin D are associated with worsening clinical outcome. Yet, clinical studies did not definitively demonstrate a benefit of Vitamin D supplementation for preventing HF or ameliorating clinical outcome in patients with established HF.

Conclusions: Despite convincing experimental and epidemiological data, treatment with Vitamin D supplementation did not show clear evidence of benefit for preventing HF or influencing its clinical course. Ongoing clinical studies will hopefully shed lights on the effects of Vitamin D supplementation on clinical endpoints along the spectrum of HF.

Keywords: Cardiovascular outcomes; Heart failure; Vitamin D deficiency; Vitamin D supplementation.

Publication types

  • Review

MeSH terms

  • Animals
  • Biomarkers / blood
  • Chronic Disease
  • Dietary Supplements
  • Heart Failure / epidemiology*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Humans
  • Parathyroid Hormone / blood
  • Prevalence
  • Risk Factors
  • Treatment Outcome
  • Ventricular Function, Left
  • Ventricular Remodeling
  • Vitamin D / blood*
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / epidemiology*
  • Vitamin D Deficiency / mortality

Substances

  • Biomarkers
  • PTH protein, human
  • Parathyroid Hormone
  • Vitamin D