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JACC:大剂量补充维生素D3可显著改善慢性心衰患者的心脏功能

2016-05-31 fsy 译 MedSci原创

慢性心力衰竭(HF)继发于左室收缩功能不全(LVSD),经常缺乏维生素D。低水平的维生素D与较差的预后有关。该VINDICATE(维生素D治疗慢性心力衰竭)研究的目的是建立高剂量维生素D3治疗由于LVSD导致的慢性HF的安全性和疗效性。研究人员招募了229例由于LVSD和维生素D缺乏(维生素D3<50 nmol/L [<20ng/ml])导致的慢性HF患者(179名男性)。参与者被分配接受维

慢性心力衰竭(HF)继发于左室收缩功能不全(LVSD),经常缺乏维生素D。低水平的维生素D与较差的预后有关。

该VINDICATE(维生素D治疗慢性心力衰竭)研究的目的是建立高剂量维生素D3治疗由于LVSD导致的慢性HF的安全性和疗效性。

研究人员招募了229例由于LVSD和维生素D缺乏(维生素D3<50 nmol/L [<20ng/ml])导致的慢性HF患者(179名男性)。参与者被分配接受维生素D3补充剂1年(4000 IU [100μg]每日)或匹配的非钙安慰剂。主要终点是基线和12个月之间6分钟步行距离的变化。次要终点包括1年时左室射血分数的变化,肾功能和血清钙浓度的安全性测量,每3个月评估一次。

一年的大剂量的补充维生素D3并不能改善1年时6分钟步行距离,但心脏功能得到明显改善(左室射血分数+6.07% [95%置信区间(CI):3.20至8.95;P<0.0001]);左心室重构逆转也得到改善(LV舒张末期内径-2.49mm[ 95% CI:-4.09至-0.90;P=0.002]和LV收缩末期内径-2.09mm[ 95% CI:-4.11至-0.06 P=0.043])。

在当时接受最佳药物治疗的患者中,每天补充100μg维生素D3,补充一年不能改善6分钟步行距离,但对于LV结构和功能是有益的。进一步的研究是必要的,以确定是否这些结果会改善患者的结局。

原始出处:

Klaus K. Witte,Rowena Byrom,John Gierula,et al.Effects of Vitamin D on Cardiac Function in Patients With Chronic HF,JACC,2016.5.31

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    2016-09-02 hbwxf
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