title: 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.
authors: Division of Geriatrics, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors: Andreas W
authors: AW
authors: Schoenenberger
authors: Renate
authors: R
authors: Schoenenberger-Berzins
authors: Christoph Auf
authors: CA
authors: der Maur
authors: Paolo M
authors: PM
authors: Suter
authors: Athanasios
authors: A
authors: Vergopoulos
authors: Paul
authors: P
authors: Erne
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D018592:Cross-Over Studies; D004232:Diuretics / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013831:Thiamine / Q000008:administration & dosage / Q000494:pharmacology* / Q000652:urine; D013832:Thiamine Deficiency / Q000139:chemically induced / Q000188:drug therapy*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D004232:Diuretics; D013831:Thiamine