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Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study


Schoenenberger, Andreas W; Schoenenberger-Berzins, Renate; Maur, Christoph Auf; Suter, Paolo M; Vergopoulos, Athanasios; Erne, Paul (2012). Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clinical Research in Cardiology, 101(3):159-164.

Abstract

BACKGROUND: Diuretic treatment for heart failure may lead to an increased urinary thiamine excretion and in long-term thiamine deficiency, which may further compromise cardiac function. This study evaluated the effect of high dose thiamine supplementation in heart failure patients.
METHODS: Nine patients with diuretic treatment for symptomatic chronic heart failure and a left ventricular ejection fraction (LVEF) <40% were randomly assigned to receive thiamine (300 mg/day) or placebo for 28 days. After a wash-out of 6 weeks, the patients crossed-over to a second treatment period. The primary outcome was a change in LVEF.
RESULTS: Mean age was 56.7 ± 9.2 years (range 44.9-75.4 years). Baseline LVEF was similar for both treatment groups (29.5% in the thiamine group and 29.5% in the placebo group, P = 0.911). After 28 days of thiamine treatment, the LVEF increased to 32.8% which was significantly (P = 0.024) different from the LVEF in the placebo group (28.8%). This corresponds to a treatment effect for LVEF of 3.9% in absolute terms.
CONCLUSIONS: This study suggests that thiamine supplementation has beneficial effects on cardiac function in patients with diuretic drugs for symptomatic chronic heart failure. Subclinical thiamine deficiency is probably an underestimated issue in these outpatients.

Abstract

BACKGROUND: Diuretic treatment for heart failure may lead to an increased urinary thiamine excretion and in long-term thiamine deficiency, which may further compromise cardiac function. This study evaluated the effect of high dose thiamine supplementation in heart failure patients.
METHODS: Nine patients with diuretic treatment for symptomatic chronic heart failure and a left ventricular ejection fraction (LVEF) <40% were randomly assigned to receive thiamine (300 mg/day) or placebo for 28 days. After a wash-out of 6 weeks, the patients crossed-over to a second treatment period. The primary outcome was a change in LVEF.
RESULTS: Mean age was 56.7 ± 9.2 years (range 44.9-75.4 years). Baseline LVEF was similar for both treatment groups (29.5% in the thiamine group and 29.5% in the placebo group, P = 0.911). After 28 days of thiamine treatment, the LVEF increased to 32.8% which was significantly (P = 0.024) different from the LVEF in the placebo group (28.8%). This corresponds to a treatment effect for LVEF of 3.9% in absolute terms.
CONCLUSIONS: This study suggests that thiamine supplementation has beneficial effects on cardiac function in patients with diuretic drugs for symptomatic chronic heart failure. Subclinical thiamine deficiency is probably an underestimated issue in these outpatients.

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Contributors:Division of Geriatrics, Department of General Internal Medicine, Inselspital, University of Bern, Department of Cardiology, Luzerner Kantonsspital
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
04 Faculty of Medicine > University Hospital Zurich > Institute of Clinical Chemistry
Dewey Decimal Classification:610 Medicine & health
540 Chemistry
Scopus Subject Areas:Health Sciences > Cardiology and Cardiovascular Medicine
Language:English
Date:2012
Deposited On:15 Feb 2013 13:48
Last Modified:23 Jan 2022 23:51
Publisher:Springer
ISSN:1861-0684
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s00392-011-0376-2