Role of thiamine supplementation in patients with heart failure – An Indian perspective

BackgroundHeart failure (HF) is a leading cause of mortality worldwide. Despite numerous therapeutic maneuvers, the prognosis remains dismal. Thiamine is an important vitamin, essential in energy formation inside the cells. Subclinical deficiency is very common in HF patients. Thiamine supplementation in such cases may improve cardiac function.ObjectivesTo assess the effect of thiamine supplementation on cardiac parameters and functional capacity in HF patients.MethodsA total of 40 HF patients with NYHA Class II and III symptoms were divided into two groups of twenty each. One group received thiamine and another placebo. Cardiac parameters (ESV, EDV, and EF) and functional capacity (6MWT) were measured at the start of the study, at 1 week and after 4 weeks.ResultsAfter 1 week of intervention in Thiamine group, ESV decreased by a mean of 6.45 ml and 6MWT improved by 27.67 m, EDV decreased by 7.1 ml and EF improved by 1.56%. In Placebo group, EDV increased by 0.93 ml and ESV and EF remained almost unchanged. 6MWT improved from 261.11 ± 49.96 to 275.78 ± 62.60 m (p = 0.01). After 4 weeks in Thiamine group, ESV decreased by 8.09 ml and EF increased by 18.65% and 6MWT by 55.35 m. In Placebo group, EDV increased by 5.25 ml and ESV decreased by 6.03%. EF and 6MWT did not show any significant change.ConclusionThiamine supplementation improves cardiac function and may prove to be an important part of HF treatment regimen particularly in India given the high prevalence of thiamine deficiency.