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

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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Acknowledgments

Andreas Schoenenberger was supported by a Forschungskolleg Geriatrie Grant from the Robert Bosch Foundation, Stuttgart, Germany.

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Corresponding author

Correspondence to Paul Erne.

Additional information

A. W. Schoenenberger and R. Schoenenberger-Berzins are equally contributed to the manuscript.

Clinical Trial Registration The study is registered at clinicaltrials.gov (NCT 00770107).

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Schoenenberger, A.W., Schoenenberger-Berzins, R., der Maur, C.A. et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol 101, 159–164 (2012). https://doi.org/10.1007/s00392-011-0376-2

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  • DOI: https://doi.org/10.1007/s00392-011-0376-2

Keywords

  • Thiamine
  • Heart failure
  • Diuretics
  • Cross-over studies