The role of vitamin D in chronic heart failure.
OBJECTIVE
Despite advanced medical and device-based therapies, congestive heart failure (CHF) remains a major medical problem, associated with significant morbidity and mortality. Vitamin D deficiency is prevalent in CHF and is associated with poor outcomes. In this manuscript we review the evidence linking vitamin D deficiency and CHF and discuss potential mechanisms involved, as well the clinical data on vitamin D supplementation in CHF patients.


RESULTS
A clear relationship has been established between Vitamin D deficiency and increased mortality and morbidity in CHF. However, the mechanism involved is not clearly understood. Recent clinical and experimental evidence have identified the renin-angiotensin-aldosterone system and inflammatory cytokines as likely mediators that can lead to poor clinical outcomes via the cardiorenal syndrome. Clinical data on vitamin D supplementation also remain unestablished, with potential clinical benefits recently reported in patients with vitamin D deficiency. Nonetheless, large-scale randomized clinical trials are lacking.


CONCLUSIONS
Vitamin D is an emerging agent with tremendous potential and may represent a novel target for therapy in CHF. Further studies are needed to identify the mechanism(s) involved in the pathophysiology as well as to adequately examine the role of Vitamin D measurement and supplementation in patients with CHF.
Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Ali
A
Pourdjabbar
Girish
G
Dwivedi
Haissam
H
Haddad
D002908:Chronic Disease; D018450:Disease Progression; D004872:Ergocalciferols / Q000008:administration & dosage; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D014807:Vitamin D / Q000502:physiology* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications* / Q000503:physiopathology; D014815:Vitamins / Q000008:administration & dosage / Q000502:physiology* / Q000627:therapeutic use
D004872:Ergocalciferols; D014815:Vitamins; D014807:Vitamin D