Remarkable Efficacy of Vitamin D in Improving Ventricular Dysfunction in Transfusion-Dependent Thalassemia Patients

Background: The purpose of this study was to investigate efficacy of high dose vitamin D in improving left ventricular ejection fraction (LVEF) in thalassemia patients with heart failure and vitamin D deficiency. Materials and Methods: This clinical trial study was conducted on 16 chronically transfused thalassemia patients and ventricular dysfunction with vitamin D deficiency between December and Jun 2018 in Thalassemia clinic, Tabriz Children Hospital. Mean age of the patients was 11.15 ± 3.61 years ranged from 8 to 18 years old. A serum 25-hydroxy vitamin D3 (25-OHD3) level less than 30ng/dl was considered vitamin D deficiency in this study. LVEF less than 55% was indicated as poor pump function. The patients received 50,000 IU of vitamin D3 weekly for 8 weeks. Data on LVEF and serum 25-OHD3 were compared before and after completing the treatment. Moreover, adverse effects were recorded during the study. Results: Means of serum 25-OHD3 levels, before and after the study, were 13.10±5.91ng/ml and 51.03±4.31ng/ml, respectively (p=0.01). Means of LVEF were13.10±5.91% and 50.27±11.93% before and after the study, respectively (p=0.03). Means of serum ferritin levels were 3913±2229 ng/ml (ranged from 1246 to11000ng/ml). Mean of cardiac magnetic resonance imaging (MRI) T2* of the patients was 11.51±5.34ms. Serum parathyroid hormone (PTH) levels of the patients decreased from the beginning of the study to the end of the eighth week (94.28 ± 18.35 vs 43.66 ± 17.31ng/ml) (p=0.03). There was a positive correlation between mean of serum 25-OHD3 level and cardiac MRI T2* parameter at the beginning of the study (r=0.001). There was a positive correlation between in the increase of mean serum 25-OHD3 and LVEF percent at the end of study (r=0.001). Conclusion: Results showed that vitamin D3 was effective and safe in improving LVEF and cardiac dysfunction in transfusion-dependent thalassemia patients with vitamin D deficiency.