RT Journal Article
SR Electronic
T1 Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e020545
DO 10.1136/bmjopen-2017-020545
VO 8
IS 8
A1 Jin-Dong Zhao
A1 Jing-Jing Jia
A1 Ping-Shuan Dong
A1 Di Zhao
A1 Xu-Ming yang
A1 Dao-Lin Li
A1 Hui-Feng Zhang
YR 2018
UL http://bmjopen.bmj.com/content/8/8/e020545.abstract
AB Objectives The level of vitamin D is considered to be associated with the development and progression of heart failure (HF). However, it is still unclear whether supplementation of vitamin D could improve ventricular remodelling in patients with HF. This study aimed to systematically evaluate the influence and safety of additional vitamin D supplementation on ventricular remodelling in patients with HF.Design This study is a meta-analysis of randomised controlled trials (RCTs).Setting The PubMed, EMBASE, CNKI, Cochrane library, Web of Science databases and grey literature were searched for RCTs regarding the effect of vitamin D on ventricular remodelling in patients with HF (from database creation to October 2017). RevMan V.5.3 software was employed for data analysis.Participants Seven RCTs with a total of 465 patients, including 235 cases in the vitamin D group and 230 cases in the control group, were included.Primary and secondary outcome measures Left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and the incidence of adverse reactions.Results Compared with the control group, a decrease in the LVEDD (mean difference (MD)=−2.31 mm, 95% CI −4.15 to −0.47, p=0.01) and an increase in the LVEF (MD=4.18%, 95% CI 0.36 to 7.99, p=0.03) were observed in the vitamin D group. Subgroup analysis also revealed a reduced LVEDD in adults (>18 years) and adolescents (<18 years) of the vitamin D group relative to that in those of the control group. High-dose vitamin D (>4000 IU/day) was more effective at reducing the LVEDD than low-dose vitamin D (<4000 IU/day). Moreover, vitamin D supplementation was more effective at reducing the LVEDD and increasing the LVEF in patients with reduced ejection fraction than in patients without reduced ejection fraction.Conclusion Vitamin D supplementation inhibits ventricular remodelling and improves cardiac function in patients with HF.Trial registration number CRD42017073893.