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Role of Vitamin D in Patients with Heart Failure with Reduced Ejection Fraction

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Abstract

Heart failure (HF) with reduced ejection fraction (HFrEF) presents as the severest phenotype on the spectrum of HF. Although great progress has been made with respect to its treatment over the past 3 decades, morbidity and mortality remain high, posing a big burden on human health. Recent evidence suggests vitamin D has a critical role in maintaining heart health through activation of the vitamin D receptor expressed in cardiomyocytes, and vitamin D deficiency may be implicated in the pathophysiology of HFrEF through activation of the renin-angiotensin system, impaired calcium handling, exaggerated inflammation, secondary hyperparathyroidism, pro-fibrotic properties, and proatherogenic potential. Additionally, epidemiological data disclosed that vitamin D deficiency is highly prevalent in patients with HFrEF and is associated with poor clinical outcomes. However, randomized control trials of vitamin D supplementation in HF, especially in HFrEF, have shown inconsistent results. Thus, this article aims to review the epidemiology, pathophysiology, and prognostic value of vitamin D deficiency in HF, with a special focus on randomized control trials associated with vitamin D supplementation in patients with HFrEF.

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  1. Meifang Wu and Kaizu Xu contributed equally to this article.

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  1. Department of Cardiology, Affiliated Hospital of Putian University, Putian, 351100, Fujian, China

    Meifang Wu, Kaizu Xu, Ying Wu & Liming Lin

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  1. Meifang Wu
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Correspondence to Ying Wu or Liming Lin.

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This study was supported by Grants from the National Natural Science Foundation of China (Grant no. 81800278) and the Natural Science Foundation of Fujian Province (Grant no. 13171570) to Dr. Liming Lin and the Natural Science Foundation of Fujian Province (Grant no. 13181097) to Dr. Meifang Wu.

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Meifang Wu, Kaizu Xu, Ying Wu, and Liming Lin declare that they have no potential conflicts of interest that might be relevant to the contents of this article.

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Wu, M., Xu, K., Wu, Y. et al. Role of Vitamin D in Patients with Heart Failure with Reduced Ejection Fraction. Am J Cardiovasc Drugs 19, 541–552 (2019). https://doi.org/10.1007/s40256-019-00357-1

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