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维生素D对收缩性心力衰竭患者左心室射血分数的影响:一项双盲随机临床试验

Effects of Vitamin D on Left Ventricular Ejection Fraction in Patients with Systolic Heart Failure: A Double-Blind Randomized Clinical Trial.

作者信息

Hassanzadeh-Makoui Reza, Jamei Maziar, Hassanzadeh-Makoui Masoud, Khederlou Hamid

机构信息

Department of Cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.

Department of Immunology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

出版信息

Int J Endocrinol Metab. 2020 Sep 2;18(3):e103528. doi: 10.5812/ijem.103528. eCollection 2020 Jul.

Abstract

BACKGROUND

Heart failure is a pathophysiologic state in which the cardiac output is not able to supply the body with enough oxygen and nutrients. The prevalence of heart failure has increased dramatically over the last decades. Vitamin D levels in patients with chronic heart failure are lower than healthy controls, and vitamin D deficiency has a direct relationship with mortality.

OBJECTIVES

This study aimed to evaluate the effect of vitamin D on the improvement of left ventricular ejection fraction in patients with systolic heart failure.

METHODS

In this case-control clinical trial, 142 patients with chronic systolic heart failure were identified. Based on the inclusion and exclusion criteria, 114 patients were enrolled in the study and randomly divided into two groups. One group (n = 58) received 50,000 units of vitamin D capsules weekly for eight weeks, and the patients in the other group (n = 56) received a placebo. After excluding 15 patients from the placebo group and 17 patients from the intervention group during the study, according to the exclusion criteria, 41 patients were evaluated in both groups for ejection fraction changes after two months.

RESULTS

According to the results of this research, there were no statistically significant differences in the baseline parameters between the two studied groups. The intervention group consisted of 18 female and 23 male patients with a mean age of 61.68 ± 19.8 years. Moreover, the placebo group included 21 female and 20 male patients with a mean age of 62.12 ± 18.2 years. After a 2-month follow-up, the intervention group showed statistically significant changes in ejection fraction, end-diastolic volume, and heart failure class compared to the placebo group. Also, the serum level of albumin and vitamin D in the intervention group was significantly higher than the placebo group.

CONCLUSIONS

The results of this study show that vitamin D treatment can improve the ejection fraction and functional ability of patients with vitamin D deficiency. If more comprehensive studies support this hypothesis, vitamin D deficiency assessment and correction in patients with chronic heart failure may be recommended.

摘要

背景

心力衰竭是一种病理生理状态,其中心输出量无法为身体提供足够的氧气和营养物质。在过去几十年中,心力衰竭的患病率急剧上升。慢性心力衰竭患者的维生素D水平低于健康对照组,且维生素D缺乏与死亡率直接相关。

目的

本研究旨在评估维生素D对改善收缩性心力衰竭患者左心室射血分数的作用。

方法

在这项病例对照临床试验中,确定了142例慢性收缩性心力衰竭患者。根据纳入和排除标准,114例患者被纳入研究并随机分为两组。一组(n = 58)每周服用50000单位维生素D胶囊,持续8周,另一组(n = 56)患者服用安慰剂。在研究期间,根据排除标准,安慰剂组排除15例患者,干预组排除17例患者,两个月后对两组中41例患者的射血分数变化进行评估。

结果

根据本研究结果,两个研究组的基线参数无统计学显著差异。干预组包括18名女性和23名男性患者,平均年龄为61.68±19.8岁。此外,安慰剂组包括21名女性和20名男性患者,平均年龄为62.12±18.2岁。经过2个月的随访,与安慰剂组相比,干预组在射血分数、舒张末期容积和心力衰竭分级方面有统计学显著变化。此外,干预组的血清白蛋白和维生素D水平显著高于安慰剂组。

结论

本研究结果表明,维生素D治疗可改善维生素D缺乏患者的射血分数和功能能力。如果更多全面的研究支持这一假设,可能建议对慢性心力衰竭患者进行维生素D缺乏评估和纠正。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3bc/7695351/eeb2f6f4dcc2/ijem-18-3-103528-i001.jpg

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