What is it about?
In healthy volunteers, experimental vitamin C deprivation has led to fatigue, dyspnea, oedema, and chest pain, which are also typical symptoms of heart failure. A few animal studies found that vitamin C can improve contractility and mechanical efficiency of the heart. We analyzed the studies that have reported on the effect of vitamin C on left ventricular ejection fraction (LVEF) in humans. In six cardiac trials with 246 patients, vitamin C increased LVEF on average by 12.0%, and in six non-cardiac trials including 177 participants, on average by 5.3%. Meta-regression analysis indicated that the effect of vitamin C is greatest in trials with the lowest baseline LVEF levels.
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Why is it important?
Textbooks often describe the effect that vitamin C has on wound healing, explaining the effect through the role of the vitamin in collagen metabolism. However, this is a simplistic view of the physiological functions of vitamin C. Biochemistry of vitamin C is complex, extending from several cofactor roles in diverse parts of metabolism to non-specific antioxidant effects, and further to wide-ranging epigenetic effects. The numerous biochemical effects can translate to diverse impacts at the clinical level. It is plausible that increased intake of vitamin C may have no beneficial effect for well-nourished healthy people, but higher doses may have effects for people under heavy physiological stress, for example during cardiac surgery or for people with heart failure. It is possible that the effect of vitamin C on the mechanical function of the heart is one of the explanations for the benefits seen in some ICU patients.
Perspectives
In the middle of the 1900s, vitamin C was suggested for treatment of heart failure, yet interest in the topic waned. It seems likely that the early findings were ignored because of wide-spread bias against vitamin C being beneficial other than for treating and preventing scurvy. The bias has been demonstrated previously in discussions within mainstream medicine on the findings from trials of vitamin C for treating the common cold. Further research on vitamin C and heart failure should be carried out, particularly in patients who have low LVEF together with low vitamin C intake or low plasma levels.
Dr Harri Hemila
Helsingin Yliopisto
Read the Original
This page is a summary of: Vitamin C May Improve Left Ventricular Ejection Fraction: A Meta-Analysis, Frontiers in Cardiovascular Medicine, February 2022, Frontiers,
DOI: 10.3389/fcvm.2022.789729.
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