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Vitamin D3 Supplementation for Heart Failure Patients

Phase 2
Completed
Conditions
Heart Failure
Vitamin D Deficiency
Cardiomyopathy
Congestive Heart Failure
Interventions
Drug: Vitamin D3 (cholecalciferol)
Registration Number
NCT01636570
Lead Sponsor
Heidi Moretti, MS, RD
Brief Summary

The purpose of this study is to determine if treatment with vitamin D3 of 10,000 International Units (IU) daily in vitamin D deficient patients for 6 months will improve B type natriuretic peptide (BNP), a marker of heart function, compared to placebo. The investigators also aim to determine if vitamin D helps cardiopulmonary function as evaluated by cardiopulmonary exercise test (CPX), laboratory values, strength, and quality of life in patients with stable congestive heart failure (Class II or III).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • NYHA Heart Failure Class II or II, stable
  • Vitamin D deficiency (32 ng/ml or less)
  • No recent medication changes for 3 months
  • Females of childbearing age must use effective contraceptive if they are sexually active
Exclusion Criteria
  • Hypercalcemia
  • Nephrolithiases
  • Sarcoidosis
  • Acute cardiac insufficiency
  • Pregnancy
  • Breastfeeding
  • Any clinically unstable medical condition
  • Supplements of greater than or equal to 1000 units of vitamin D per day

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Vitamin D3 (cholecalciferol)Vitamin D3 (cholecalciferol)10,000 International Units of vitamin D3 will be given daily for 6 months in vitamin D deficient heart failure patients.
Primary Outcome Measures
NameTimeMethod
B type Natriuretic Peptide (BNP)Change in BNP will be measured at baseline and after 6 months of treatment with vitamin D or placebo

BNP is a hormone secreted by the heart ventricles, and high concentrations of this hormone occur in heart failure. It is a strong prognostic indicator.

Secondary Outcome Measures
NameTimeMethod
Cardiopulmonary exercise test (CPX)Change in CPX will be measured at baseline and after 6 months of treatment with Vitamin D3 or placebo

Secondary outcome measure will include improvements from baseline in cardiopulmonary function as evaluated by CPX(includes measurement of the change in ventilator efficiency (VE/VCO2), partial pressure of end-tidal CO2 (PETCO2)

25 hydroxyvitamin D [25 (OH)D]Change in 25 hydroxyvitamin D will be measured at baseline, at 12 weeks, and after 6 months of treatment with vitamin D or placebo

Patients with vitamin D deficiency as defined by 25(OH)D of less than 32 ng/ml. 25(OH)D is the most accurate measurement for assessment of vitamin D status. However, ideal ranges for serum 25 (OH)D have not been well established. A recent pharmokinetic study conducted by Hollis, et al, found that 25 OHD levels had to exceed 40 ng/ml and sometimes 50 ng/ml, for the parent substrate (cholecalciferol) to be detectable in the blood (Hollis 2007. IF 25(OH)D levels exceed 150 ng/ml, they will be withdrawn from the study to avoid toxicity.

C reactive protein (CRP)Change in CRP will be measured at baseline and after 6 months of treatment with vitamin D or placebo

CRP is related to heart failure incidence, and vitamin D seems to be inversely related to CRP levels.

Serum CalciumChange in serum calcium levels will be measured at baseline, at 12 weeks, and at 6 months of treatment with vitamin D or placebo

Measurement of serum calcium levels will help to assess safety of vitamin D treatment. If serum calcium becomes elevated, patients will be withdrawn from the clinical trial.

6 minute walk testChange in the 6 minute walk test will be measured at baseline and at 6 months of treatment with vitamin D or placebo

The 6 minute walk test is used to measure aerobic activity at baseline and after completion of supplemental vitamin D or placebo. This test is an objective measurement of exercise capacity, and has been shown to be reproducible and a suitable measure for outcome in patients with heart failure (Guyatt). The 6 minute walk test in heart failure patients is strongly associated with vitamin D serum concentrations (p=0.002) and inversely with high sensitivity C reactive protein (hsCRP), an inflammatory marker (p=0.001)

Kansas City Cardiomyopathy QuestionnaireChang in the KCCQ will be measured at baseline and after 6 months of treatment with vitamin D or placebo

Measurements of quality of life provide means of measuring prospective benefits of heart failure interventions. The KCCQ is associated with hospitalization and mortality, and is sensitive to changes in heart function with ARB, beta-blocker and ACE inhibitor treatment.

Trial Locations

Locations (2)

International Heart Institute of Montana

🇺🇸

Missoula, Montana, United States

Saint Patrick Hosptial

🇺🇸

Missoula, Montana, United States

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