Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy

Shimon, Han; Almog, Shlomo; Vered, Zvi; Seligmann, H; Shefi, M; Peleg, Edna; Rosenthal, Talma; Motro, Michael; Halkin, Hillel; Ezra, David

doi:10.1016/s0002-9343(99)80349-0

Cited by 184 publications

(136 citation statements)

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“…Seligmann [13] reported an average increase of 10 mm Hg in systolic and diastolic blood pressure in their thiamine deficient patients by 7 days of intravenous thiamine administration [13]. Shimon and associates did not report any significant change in blood pressure in thiamine group [23]. In our study there was no significant change in blood pressure or heart rate of heart failure patients treated with thiamine (Table 3).…”

Section: Discussionsupporting

confidence: 39%

“…Seligmann and colleagues and reported that oral thiamine supplementation increased left ventricular ejection fraction in 5 heart failure patients with thiamine deficiency [13]. Shimon and associates as well as Schoenenberger and coworkers reported similar results in heart failure patients with long-term diuretic therapy [23,24]. Witte et al prescribed capsules containing a combination of high-dose micronutrients including thiamine to 30 heart failure patients for 9 months and reported a reduction in LV volumes and an increase in LVEF [25].…”

Section: Discussionmentioning

confidence: 99%

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Thiamine Supplementation in Patients with Chronic Heart Failure Receiving Optimum Medical Treatment

2017

JCCR

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Background: Thiamine deficiency may cause heart failure and symptoms including edema, palpitation, tachycardia, weakness, malaise, and dyspnea due to water and salt retention and peripheral vasodilation. Patients with heart failure might be thiamine deficient and benefit thiamine supplementation. This study was designed to evaluate the effect of thiamin supplementation on some systolic and diastolic echocardiographic parameters and signs and symptoms of heart failure.Methods: Fifty two patients with systolic heart failure (LVEF < 40%) receiving optimum medical treatment, were randomized to receive 300mg thiamine or placebo for 1 month in a double-blind fashion (26 patients in each group). Echocardiographies were performed before and after treatment by a single investigator and sign and symptoms were evaluated (clinicaltrials.gov Identifier # NCT01115504). Results:Mean age was 61.44 ± 11.8 years and 67.3% were male. Maximal systolic tissue velocity of of septal and lateral walls (Sm waves) increased 0. 99 ± 1.46 and 0.83 ± 1.58 cm/s in thiamine group and changed 0.005± 1.63 and -0.1 ± 1.83 cm/s in placebo group (P = 0.033 and P = 0.044) respectievely. Ejection fraction or diastolic echocardiographic parameters were not influenced by thiamine supplementation and there was no significant effect on daily activities and dyspnea. However, peripheraledema improved in 9 patients (34.6%) of thiamine group versus 1 of the placebo group (3.8%) (P = 0.005). Conclusion:In the present study thiamine supplementation had some positive effect on edema and systolic function through an increase of lateral and septal Sm. However usefulness of routine supplementation needs more study Keywords: Thiamine; Heart failure; Edema; Signs and Symptoms, regimen of the patients in the past 3 months, due to aggravated symptoms or optimization of dosage for a survival benefit according to the present guidelines. Excluded patients were those with decompensated heart failure, bradycardia or tachycardia (needing a change in drug dosage or regimen), concomitant medical illness e.g. chronic renal failure, chronic obstructive pulmonary disease, asthma and uncontrolled hypertension.The study was a single-site randomized placebo-controlled double blind trial and enrolled patients were randomized by means of block randomization method by a single pharmacist. Patients were assigned to randomly receive 300mg daily of thiamine (HakimVitamin B1300®, Hakim pharmaceutical industry, Tehran, Iran) (n=26, thiamine group) or placebo (Hakim pharmaceutical industry, Tehran, Iran) (n=26, placebo group) for 30 days in a double-blind fashion.At randomization and at the end of study, echocardiography (Sonace 8000 EX, South Korea) was performed by a single operator in a blinded fashion. Ejection fraction was measured in 2D echocardiography in apical 4 chamber and apical 2 chamber views by means of Simpson method. Maximal systolic velocity of myocardial tissue of septal and lateral walls (Sm waves) were obtained by tissue Doppler imaging of lateral and septal wal...

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Section: Discussionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 99%

Thiamine Supplementation in Patients with Chronic Heart Failure Receiving Optimum Medical Treatment

2017

JCCR

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“…The improvement in LVEF after thiamine replacement has been consistently demonstrated in other studies 13,15 . Shimon I et al 15 demonstrated an increased in LVEF of 22% in 27 patients of heart failure who were put on 6 weeks of oral thiamine treatment in their study.…”

Section: Discussion:-supporting

confidence: 76%

“…Hanna Seligmann et al 13 demonstrated a mean increase of urinary output of 500ml/24 hours with an average weight loss of 1kg in thiamine treatment group. Brisk diuresis was similarly shown by Ilan Shimon et al 15 in their thiamine treatment cohort of heart failure patients.…”

Section: Discussion:-supporting

confidence: 58%

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Role of Thiamine Deficiency and Efficacy of Thiamine in Treatment of Patients With Heart Failure.

Iqbal¹,

Abdullah²,

Nuzhat³

et al. 2017

IJAR

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Thiamine is a water soluble B-complex vitamin readily available in cereal grains, yeast, nuts and meat products. It combines with adenosine triphosphate in liver, kidneys and leukocyte to form thiamine pyrophosphate, a coenzyme in carbohydrate metabolism 1 .Diagnosis of thiamine deficiency is frequently obtained by measuring thiamine pyrophosphate effect (TPPE). TPPE reflects thiamine concentrations on the basis of activity of thiamine diphosphate on the transketolase enzyme of pentose shunt 2 .A thiamine pyrophosphate effect of 0 to 15% is considered normal, 15% to 24% indicative of marginal deficiency, and >25% associated with several deficiency 3 .Thiamine status can be assessed also by direct measurement of thiamine pyrophosphate in erythrocytes or whole blood by high performance liquid chromatography (HPLC). This method is precise and yields results similar to erythrocyte activation assay 4 .Specific signs and symptoms observed in thiamine-deficient patients represent alterations in the biochemistry of thiamine that result in impaired oxidative phosphorylation, increased levels of proximal metabolites (pyruvate), and decreased transketolase activity in RBCs, liver, heart and other organs. Thiamine deficiency manifests as dry or wet beri beri. Dry beri beri involves peripheral neuropathy that can be permanent even following thiamine repletion. Neurological side effects of thiamine deficiency can progress to Wernicke-koraskoff syndrome 5 .Heart failure (HF) is a common, disabling and costly disease throughout the world. The recommended pharmacological therapy includes the use of angiotensin converting enzyme inhibitors, angiotensin receptor

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Diuretics in Congestive Heart Failure

Ross¹,

Hershberger²,

Ellison

2006

Heart Failure: Pharmacologic Management

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Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy

Cited by 184 publications

References 20 publications

Thiamine Supplementation in Patients with Chronic Heart Failure Receiving Optimum Medical Treatment

Thiamine Supplementation in Patients with Chronic Heart Failure Receiving Optimum Medical Treatment

Role of Thiamine Deficiency and Efficacy of Thiamine in Treatment of Patients With Heart Failure.

Diuretics in Congestive Heart Failure

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