Congestive Heart Failure

A 2001 review concluded that there was insufficient evidence from large trials to confirm thiamine as a corrective treatment in congestive heart failure (CHF); however, prophylactic supplementation was worthwhile considering the high prevalence of deficiency in this population (Blanc & Boussuges 2001). The largest and most recent trial since then was published in 2006 and confirmed that the incidence of deficiency is notable in this population (Hanninen et al 2006). It is suspected that patients with existing heart failure are at increased risk of thiamine deficiency because of diuretic-induced depletion, advanced age, malnutrition or periods of hospitalisation.

A number of small interventional studies have assessed the effect of thiamine supplementation in patients with CHF with promising results. In one pilot study six patients treated with IV thiamine, such that their thiamine status returned to normal, resulted in increased left ventricular ejection fraction (LVEF) in four of five of patients studied by ECG (Seligman et al 1991). A randomised, placebo-controlled, doubleblind study of 30 patients compared the effects of IV thiamine (200 mg/day) to © 2007 Elsevier Australia

placebo over 1 week followed by oral thiamine (200 mg/day) taken for 6 weeks. In the 27 patients completing the full 7-week intervention, LVEF rose by 22%. Other positive results have been reported from similar studies (Hanninen et al 2006).

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