Correspondence

Is There a Role for Thiamine in the Management of Congestive Heart Failure?

Authors: Muhammad Wasif Saif MD, MBBS

Abstract

To the Editor:


Congestive heart failure (CHF) is an important public health concern. It afflicts an estimated 4 million Americans and is a leading cause of morbidity and mortality. Deficiency of thiamine intake can lead to impaired cardiac performance in the form of beriberi heart disease. Loop diuretics, such as furosemide (Lasix), have been shown to cause thiamine deficiency in experimental animals and patients with CHF. We report the case of a patient with severe CHF whose ejection fraction as well as New York Heart Association (NYHA) grade of dyspnea improved after thiamine supplementation.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: Effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999; 134: 232–237.
 
2. Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996; 131: 1248–1250.
 
3. Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: A pilot study. Am J Med 1991; 91: 151–155.
 
4. Hardig L, Daae C, Dellborg M, Kontny F, Bohmer T. Reduced thiamine phosphate, but not thiamine diphosphate, in erythrocytes in elderly patients with congestive heart failure treated with furosemide. J Intern Med 2000; 247: 597–600.
 
5. Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995; 98: 485–490.