Details

Autor(en) / Beteiligte

• Tamez, Hector, MD, MPH
• Zoccali, Carmine, MD
• Packham, David, MD
• Wenger, Julia, MPH
• Bhan, Ishir, MD, MPH
• Appelbaum, Evan, MD, MM, Sci
• Pritchett, Yili, PhD
• Chang, Yuchiao, PhD
• Agarwal, Rajiv, MD
• Wanner, Christoph, MD
• Lloyd-Jones, Donald, MD, ScD
• Cannata, Jorge, MD
• Thompson, B. Taylor, MD
• Andress, Dennis, MD
• Zhang, Wuyan, PhD
• Singh, Bhupinder, MD
• Zehnder, Daniel, MD
• Pachika, Ajay, MD
• Manning, Warren J., MD
• Shah, Amil, MD
• Solomon, Scott D., MD
• Thadhani, Ravi, MD, MPH

Titel

Vitamin D reduces left atrial volume in patients with left ventricular hypertrophy and chronic kidney disease

Ist Teil von

• The American heart journal, 2012-12, Vol.164 (6), p.902-909.e2

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Left atrial enlargement, a sensitive integrator of left ventricular diastolic function, is associated with increased cardiovascular morbidity and mortality. Vitamin D is linked to lower cardiovascular morbidity, possibly modifying cardiac structure and function; however, firm evidence is lacking. We assessed the effect of an activated vitamin D analog on left atrial volume index (LAVi) in a post hoc analysis of the PRIMO trial (clinicaltrials.gov: NCT00497146). Methods and results One hundred ninety-six patients with chronic kidney disease (estimated glomerular filtration rate 15-60 mL/min per 1.73m2 ), mild to moderate left ventricular hypertrophy, and preserved ejection fraction were randomly assigned to 2 μg of oral paricalcitol or matching placebo for 48 weeks. Two-dimensional echocardiography was obtained at baseline and at 24 and 48 weeks after initiation of therapy. Over the study period, there was a significant decrease in LAVi (−2.79 mL/m2 , 95% CI −4.00 to −1.59 mL/m2 ) in the paricalcitol group compared with the placebo group (−0.70 mL/m2 [95% CI −1.93 to 0.53 mL/m2 ], P = .002). Paricalcitol also attenuated the rise in levels of brain natriuretic peptide (10.8% in paricalcitol vs 21.3% in placebo, P = .02). For the entire population, the change in brain natriuretic peptide correlated with change in LAVi ( r = 0.17, P = .03). Conclusions Forty-eight weeks of therapy with an active vitamin D analog reduces LAVi and attenuates the rise of BNP. In a population where only few therapies alter cardiovascular related morbidity and mortality, these post hoc results warrant further confirmation.