title: A randomized controlled trial of high dose vitamin D3 in patients with heart failure.
abstract: OBJECTIVE
  To investigate the effect of Vitamin D3 on physical performance in patients with HF.
  
  
  BACKGROUND
  HF is associated with functional decline and frailty. Vitamin D deficiency is associated with loss of muscle strength and poor outcomes in patients with HF.
  
  
  METHODS
  Sixty-four patients participated in a 6-month parallel design double blind RCT to test the hypothesis that oral vitamin D3 would improve physical performance. Vitamin D3 50,000 IU or placebo was given weekly; all received daily calcium. Patients were included regardless of EF and 25OHD ≤ 37.5 ng/ml. The primary outcome was peak VO2, and secondary outcomes were the 6MW, TGUG and knee isokinetic muscle strength. Between group comparisons were made using ANCOVA models that adjust for baseline measures.
  
  
  RESULTS
  Patients were age 65.9 ± 10.4 years old, 48% women, 64% African American, EF 37.6±13.9, 36% NYHA III, the remainder NYHA II. At baseline the vitamin D group 25OHD was 19.1 ± 9.3 ng/ml and increased to 61.7 ± 20.3 ng/ml; in the placebo group baseline 25OHD was 17.8 ± 9.0 ng/ml and decreased to 17.4 ± 9.8 ng/ml at 6 months (between groups p<0.001). There was no significant change from baseline to 6 months in peak VO2, 6MW, TGUG or isokinetic muscle strength.
  
  
  CONCLUSIONS
  Vitamin D3 did not improve physical performance for patients with HF despite a robust increase in serum 25OHD. Vitamin D repletion in patients with HF should conform to standard adult guidelines for vitamin D supplementation.
authors.affiliation: Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Boxer
authors.affiliation: Center on Aging, Department of Medicine, University of Connecticut, Farmington, Connecticut.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kenny
authors.affiliation: Center for Clinical Investigation, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Schmotzer
authors.affiliation: Harrington Heart and Vascular Institute, Department of Medicine, Case Western Reserve University.
authors.forename: Marianne
authors.initials: M
authors.lastname: Vest
authors.affiliation: Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Fiutem
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, New York, New York.
authors.forename: Ileana L
authors.initials: IL
authors.lastname: Piña
mesh_terms: D000368:Aged; D002762:Cholecalciferol / Q000008:administration & dosage*; D004311:Double-Blind Method; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000187:drug effects; D018482:Muscle, Skeletal / Q000187:drug effects; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D002762:Cholecalciferol
keywords: heart failure; trial; vitamin D