title: Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review.
abstract: Diuretic therapy is a cornerstone in the management of heart failure. Most studies assessing body thiamine status have reported variable degrees of thiamine deficiency in patients with heart failure, particularly those treated chronically with high doses of furosemide. Thiamine deficiency in patients with heart failure seems predominantly to be due to increased urine volume and urinary flow rate. There is also evidence that furosemide may directly inhibit thiamine uptake at the cellular level. Limited data suggest that thiamine supplementation is capable of increasing left ventricular ejection fraction and improving functional capacity in patients with heart failure and a reduced left ventricular ejection fraction who were treated with diuretics (predominantly furosemide). Therefore, it may be reasonable to provide such patients with thiamine supplementation during heart failure exacerbations.
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia.
authors.forename: Natraj
authors.initials: N
authors.lastname: Katta
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia.
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Balla
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia. Electronic address: alpertm@health.missouri.edu.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Alpert
mesh_terms: D019587:Dietary Supplements; D005665:Furosemide / Q000009:adverse effects*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000009:adverse effects*; D013318:Stroke Volume; D013831:Thiamine / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000139:chemically induced* / Q000188:drug therapy; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D049994:Sodium Potassium Chloride Symporter Inhibitors; D014803:Vitamin B Complex; D005665:Furosemide; D013831:Thiamine
keywords: Furosemide; Heart failure; Thiamine; Thiamine deficiency