title: Effects of Vitamin D on Cardiac Function in Patients With Chronic HF: The VINDICATE Study.
abstract: BACKGROUND
  Patients with chronic heart failure (HF) secondary to left ventricular systolic dysfunction (LVSD) are frequently deficient in vitamin D. Low vitamin D levels are associated with a worse prognosis.
  
  
  OBJECTIVE
  The VINDICATE (VitamIN D treatIng patients with Chronic heArT failurE) study was undertaken to establish safety and efficacy of high-dose 25 (OH) vitamin D3 (cholecalciferol) supplementation in patients with chronic HF due to LVSD.
  
  
  METHODS
  We enrolled 229 patients (179 men) with chronic HF due to LVSD and vitamin D deficiency (cholecalciferol <50 nmol/l [<20 ng/ml]). Participants were allocated to 1 year of vitamin D3 supplementation (4,000 IU [100 μg] daily) or matching non-calcium-based placebo. The primary endpoint was change in 6-minute walk distance between baseline and 12 months. Secondary endpoints included change in LV ejection fraction at 1 year, and safety measures of renal function and serum calcium concentration assessed every 3 months.
  
  
  RESULTS
  One year of high-dose vitamin D3 supplementation did not improve 6-min walk distance at 1 year, but was associated with a significant improvement in cardiac function (LV ejection fraction +6.07% [95% confidence interval (CI): 3.20 to 8.95; p < 0.0001]); and a reversal of LV remodeling (LV end diastolic diameter -2.49 mm [95% CI: -4.09 to -0.90; p = 0.002] and LV end systolic diameter -2.09 mm [95% CI: -4.11 to -0.06 p = 0.043]).
  
  
  CONCLUSIONS
  One year of 100 μg daily vitamin D3 supplementation does not improve 6-min walk distance but has beneficial effects on LV structure and function in patients on contemporary optimal medical therapy. Further studies are necessary to determine whether these translate to improvements in outcomes. (VitamIN D Treating patIents With Chronic heArT failurE [VINDICATE]; NCT01619891).
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom. Electronic address: k.k.witte@leeds.ac.uk.
authors.forename: Klaus K
authors.initials: KK
authors.lastname: Witte
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Rowena
authors.initials: R
authors.lastname: Byrom
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Gierula
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Paton
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Haqeel A
authors.initials: HA
authors.lastname: Jamil
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Lowry
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Department of Cardiology, Leeds, United Kingdom.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Gillott
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Department of Cardiology, Leeds, United Kingdom.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Barnes
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Hemant
authors.initials: H
authors.lastname: Chumun
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Lorraine C
authors.initials: LC
authors.lastname: Kearney
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: John P
authors.initials: JP
authors.lastname: Greenwood
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Graham R
authors.initials: GR
authors.lastname: Law
authors.affiliation: School of Dentistry, University of Leeds, Leeds, United Kingdom.
authors.forename: Sue
authors.initials: S
authors.lastname: Pavitt
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Department of Clinical Biochemistry, Leeds, United Kingdom.
authors.forename: Julian H
authors.initials: JH
authors.lastname: Barth
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Cubbon
authors.affiliation: Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Kearney
mesh_terms: D000368:Aged; D002112:Calcifediol / Q000097:blood; D002117:Calcitriol / Q000097:blood; D002762:Cholecalciferol / Q000008:administration & dosage*; D004311:Double-Blind Method; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy*; D020257:Ventricular Remodeling / Q000187:drug effects; D014815:Vitamins / Q000008:administration & dosage*; D000070857:Walk Test
chemical_list: D014815:Vitamins; D002762:Cholecalciferol; D002117:Calcitriol; D002112:Calcifediol
keywords: heart failure; left ventricular function; remodeling; vitamin D