Effect of paricalcitol on left ventricular mass and function in CKD--the OPERA trial.
Identifieur interne : 000406 ( Main/Exploration ); précédent : 000405; suivant : 000407Effect of paricalcitol on left ventricular mass and function in CKD--the OPERA trial.
Auteurs : Angela Yee-Moon Wang [Hong Kong] ; Fang Fang ; John Chan ; Yue-Yi Wen ; Shang Qing ; Iris Hiu-Shuen Chan ; Gladys Lo ; Kar-Neng Lai ; Wai-Kei Lo ; Christopher Wai-Kei Lam ; Cheuk-Man YuSource :
- Journal of the American Society of Nephrology : JASN ; 2014.
English descriptors
- KwdEn :
- Aged, Alkaline Phosphatase (blood), Blood Pressure (drug effects), Double-Blind Method, Echocardiography, Ergocalciferols (adverse effects), Ergocalciferols (therapeutic use), Female, Humans, Hypercalcemia (chemically induced), Hypertrophy, Left Ventricular (drug therapy), Hypertrophy, Left Ventricular (etiology), Hypertrophy, Left Ventricular (pathology), Magnetic Resonance Imaging, Male, Middle Aged, Parathyroid Hormone (blood), Prospective Studies, Renal Insufficiency, Chronic (complications), Renal Insufficiency, Chronic (drug therapy), Renal Insufficiency, Chronic (pathology), Ventricular Dysfunction, Left (drug therapy), Ventricular Dysfunction, Left (etiology), Ventricular Dysfunction, Left (physiopathology).
- MESH :
- chemical , adverse effects : Ergocalciferols.
- chemical , blood : Alkaline Phosphatase, Parathyroid Hormone.
- chemically induced : Hypercalcemia.
- complications : Renal Insufficiency, Chronic.
- drug effects : Blood Pressure.
- drug therapy : Hypertrophy, Left Ventricular, Renal Insufficiency, Chronic, Ventricular Dysfunction, Left.
- etiology : Hypertrophy, Left Ventricular, Ventricular Dysfunction, Left.
- pathology : Hypertrophy, Left Ventricular, Renal Insufficiency, Chronic.
- physiopathology : Ventricular Dysfunction, Left.
- chemical , therapeutic use : Ergocalciferols.
- Aged, Double-Blind Method, Echocardiography, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies.
Abstract
Vitamin D seems to protect against cardiovascular disease, but the reported effects of vitamin D on patient outcomes in CKD are controversial. We conducted a prospective, double blind, randomized, placebo-controlled trial to determine whether oral activated vitamin D reduces left ventricular (LV) mass in patients with stages 3-5 CKD with LV hypertrophy. Subjects with echocardiographic criteria of LV hypertrophy were randomly assigned to receive either oral paricalcitol (1 μg) one time daily (n=30) or matching placebo (n=30) for 52 weeks. The primary end point was change in LV mass index over 52 weeks, which was measured by cardiac magnetic resonance imaging. Secondary end points included changes in LV volume, echocardiographic measures of systolic and diastolic function, biochemical parameters of mineral bone disease, and measures of renal function. Change in LV mass index did not differ significantly between groups (median [interquartile range], -2.59 [-6.13 to 0.32] g/m(2) with paricalcitol versus -4.85 [-9.89 to 1.10] g/m(2) with placebo). Changes in LV volume, ejection fraction, tissue Doppler-derived measures of early diastolic and systolic mitral annular velocities, and ratio of early mitral inflow velocity to early diastolic mitral annular velocity did not differ between the groups. However, paricalcitol treatment significantly reduced intact parathyroid hormone (P<0.001) and alkaline phosphatase (P=0.001) levels as well as the number of cardiovascular-related hospitalizations compared with placebo. In conclusion, 52 weeks of treatment with oral paricalcitol (1 μg one time daily) significantly improved secondary hyperparathyroidism but did not alter measures of LV structure and function in patients with severe CKD.
DOI: 10.1681/ASN.2013010103
PubMed: 24052631
Affiliations:
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Le document en format XML
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first="Yue-Yi" last="Wen">Yue-Yi Wen</name></author><author><name sortKey="Qing, Shang" sort="Qing, Shang" uniqKey="Qing S" first="Shang" last="Qing">Shang Qing</name></author><author><name sortKey="Chan, Iris Hiu Shuen" sort="Chan, Iris Hiu Shuen" uniqKey="Chan I" first="Iris Hiu-Shuen" last="Chan">Iris Hiu-Shuen Chan</name></author><author><name sortKey="Lo, Gladys" sort="Lo, Gladys" uniqKey="Lo G" first="Gladys" last="Lo">Gladys Lo</name></author><author><name sortKey="Lai, Kar Neng" sort="Lai, Kar Neng" uniqKey="Lai K" first="Kar-Neng" last="Lai">Kar-Neng Lai</name></author><author><name sortKey="Lo, Wai Kei" sort="Lo, Wai Kei" uniqKey="Lo W" first="Wai-Kei" last="Lo">Wai-Kei Lo</name></author><author><name sortKey="Lam, Christopher Wai Kei" sort="Lam, Christopher Wai Kei" uniqKey="Lam C" first="Christopher Wai-Kei" last="Lam">Christopher Wai-Kei Lam</name></author><author><name sortKey="Yu, Cheuk Man" sort="Yu, Cheuk Man" uniqKey="Yu C" first="Cheuk-Man" last="Yu">Cheuk-Man 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Yee-Moon Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong;</nlm:affiliation><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Medicine, Queen Mary Hospital, University of Hong Kong</wicri:regionArea><wicri:noRegion>University of Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Fang, Fang" sort="Fang, Fang" uniqKey="Fang F" first="Fang" last="Fang">Fang Fang</name></author><author><name sortKey="Chan, John" sort="Chan, John" uniqKey="Chan J" first="John" last="Chan">John Chan</name></author><author><name sortKey="Wen, Yue Yi" sort="Wen, Yue Yi" uniqKey="Wen Y" first="Yue-Yi" last="Wen">Yue-Yi Wen</name></author><author><name sortKey="Qing, Shang" sort="Qing, Shang" uniqKey="Qing S" first="Shang" last="Qing">Shang Qing</name></author><author><name sortKey="Chan, Iris Hiu Shuen" sort="Chan, Iris Hiu Shuen" uniqKey="Chan I" first="Iris Hiu-Shuen" last="Chan">Iris Hiu-Shuen Chan</name></author><author><name sortKey="Lo, Gladys" sort="Lo, Gladys" uniqKey="Lo G" first="Gladys" last="Lo">Gladys Lo</name></author><author><name sortKey="Lai, Kar Neng" sort="Lai, Kar Neng" uniqKey="Lai K" first="Kar-Neng" last="Lai">Kar-Neng Lai</name></author><author><name sortKey="Lo, Wai Kei" sort="Lo, Wai Kei" uniqKey="Lo W" first="Wai-Kei" last="Lo">Wai-Kei Lo</name></author><author><name sortKey="Lam, Christopher Wai Kei" sort="Lam, Christopher Wai Kei" uniqKey="Lam C" first="Christopher Wai-Kei" last="Lam">Christopher Wai-Kei Lam</name></author><author><name sortKey="Yu, Cheuk Man" sort="Yu, Cheuk Man" uniqKey="Yu C" first="Cheuk-Man" last="Yu">Cheuk-Man Yu</name></author></analytic><series><title level="j">Journal of the American Society of Nephrology : JASN</title><idno type="e-ISSN">1533-3450</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Alkaline Phosphatase (blood)</term><term>Blood Pressure (drug effects)</term><term>Double-Blind Method</term><term>Echocardiography</term><term>Ergocalciferols (adverse effects)</term><term>Ergocalciferols (therapeutic use)</term><term>Female</term><term>Humans</term><term>Hypercalcemia (chemically induced)</term><term>Hypertrophy, Left Ventricular (drug therapy)</term><term>Hypertrophy, Left Ventricular (etiology)</term><term>Hypertrophy, Left Ventricular (pathology)</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Parathyroid Hormone (blood)</term><term>Prospective Studies</term><term>Renal Insufficiency, Chronic (complications)</term><term>Renal Insufficiency, Chronic (drug therapy)</term><term>Renal Insufficiency, Chronic (pathology)</term><term>Ventricular Dysfunction, Left (drug therapy)</term><term>Ventricular Dysfunction, Left (etiology)</term><term>Ventricular Dysfunction, Left (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Ergocalciferols</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Alkaline Phosphatase</term><term>Parathyroid Hormone</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Hypercalcemia</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Renal Insufficiency, Chronic</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Blood Pressure</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Hypertrophy, Left Ventricular</term><term>Renal Insufficiency, Chronic</term><term>Ventricular Dysfunction, Left</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hypertrophy, Left Ventricular</term><term>Ventricular Dysfunction, Left</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Hypertrophy, Left Ventricular</term><term>Renal Insufficiency, Chronic</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Ventricular Dysfunction, Left</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Ergocalciferols</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Double-Blind Method</term><term>Echocardiography</term><term>Female</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Vitamin D seems to protect against cardiovascular disease, but the reported effects of vitamin D on patient outcomes in CKD are controversial. We conducted a prospective, double blind, randomized, placebo-controlled trial to determine whether oral activated vitamin D reduces left ventricular (LV) mass in patients with stages 3-5 CKD with LV hypertrophy. Subjects with echocardiographic criteria of LV hypertrophy were randomly assigned to receive either oral paricalcitol (1 μg) one time daily (n=30) or matching placebo (n=30) for 52 weeks. The primary end point was change in LV mass index over 52 weeks, which was measured by cardiac magnetic resonance imaging. Secondary end points included changes in LV volume, echocardiographic measures of systolic and diastolic function, biochemical parameters of mineral bone disease, and measures of renal function. Change in LV mass index did not differ significantly between groups (median [interquartile range], -2.59 [-6.13 to 0.32] g/m(2) with paricalcitol versus -4.85 [-9.89 to 1.10] g/m(2) with placebo). Changes in LV volume, ejection fraction, tissue Doppler-derived measures of early diastolic and systolic mitral annular velocities, and ratio of early mitral inflow velocity to early diastolic mitral annular velocity did not differ between the groups. However, paricalcitol treatment significantly reduced intact parathyroid hormone (P<0.001) and alkaline phosphatase (P=0.001) levels as well as the number of cardiovascular-related hospitalizations compared with placebo. In conclusion, 52 weeks of treatment with oral paricalcitol (1 μg one time daily) significantly improved secondary hyperparathyroidism but did not alter measures of LV structure and function in patients with severe CKD.</div></front></TEI><affiliations><list><country><li>Hong Kong</li></country></list><tree><noCountry><name sortKey="Chan, Iris Hiu Shuen" sort="Chan, Iris Hiu Shuen" uniqKey="Chan I" first="Iris Hiu-Shuen" last="Chan">Iris Hiu-Shuen Chan</name><name sortKey="Chan, John" sort="Chan, John" uniqKey="Chan J" first="John" last="Chan">John Chan</name><name sortKey="Fang, Fang" sort="Fang, Fang" uniqKey="Fang F" first="Fang" last="Fang">Fang Fang</name><name sortKey="Lai, Kar Neng" sort="Lai, Kar Neng" uniqKey="Lai K" first="Kar-Neng" last="Lai">Kar-Neng Lai</name><name sortKey="Lam, Christopher Wai Kei" sort="Lam, Christopher Wai Kei" uniqKey="Lam C" first="Christopher Wai-Kei" last="Lam">Christopher Wai-Kei Lam</name><name sortKey="Lo, Gladys" sort="Lo, Gladys" uniqKey="Lo G" first="Gladys" last="Lo">Gladys Lo</name><name sortKey="Lo, Wai Kei" sort="Lo, Wai Kei" uniqKey="Lo W" first="Wai-Kei" last="Lo">Wai-Kei Lo</name><name sortKey="Qing, Shang" sort="Qing, Shang" uniqKey="Qing S" first="Shang" last="Qing">Shang Qing</name><name sortKey="Wen, Yue Yi" sort="Wen, Yue Yi" uniqKey="Wen Y" first="Yue-Yi" last="Wen">Yue-Yi Wen</name><name sortKey="Yu, Cheuk Man" sort="Yu, Cheuk Man" uniqKey="Yu C" first="Cheuk-Man" last="Yu">Cheuk-Man Yu</name></noCountry><country name="Hong Kong"><noRegion><name sortKey="Wang, Angela Yee Moon" sort="Wang, Angela Yee Moon" uniqKey="Wang A" first="Angela Yee-Moon" last="Wang">Angela Yee-Moon Wang</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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