Thiamin is a required coenzyme in the production of energy to fuel myocardial contraction. Therefore, thiamin deficiency (TD) may contribute to myocardial weakness by limiting the available energy for myocyte contraction. Previous studies report a wide range for the prevalence of TD in patients with heart failure (HF) (3% to 91%). These trials are limited by their small sample size, indirect measurement of thiamin status, exclusion criteria, and their focus on hospitalized patients. Therefore, this study determined the prevalence of TD in a large (n=100) group of ambulatory patients with HF, using high performance liquid chromotography. The prevalence of TD ([thiamin pyrophosphate (TPP)] ≤ 180 nM/l erythrocytes) was found to be 7%. TD was not related to furosemide use, dietary thiamin intake, severity of the HF, or age. More investigation into the factors that may influence development of TD in ambulatory patients with HF is warranted.

Thiamin is a required coenzyme in energy producing reactions that subsequently fuel myocardial contraction. Therefore, thiamin deficiency (TD) might contribute to the reduction in myocardial function observed in patients with heart failure (HF) by limiting the available energy and subsequently aggravating cardiac performance. While the prevalence of TD as well as the impact of supplementation has been examined in patients with HF, none of these studies to date has examined the impact of TD on clinical outcomes. Therefore, this study investigated the associations between erythrocyte [TPP] levels and outcomes in ambulatory patients with HF. Time-to-event probabilities were found to be not significant for acute decompensated heart failure, mortality, all-cause hospitalizations, arrhythmias, myocardial infarctions and other adverse events. Further investigations into the longer term impact of TD on outcomes and the effects of thiamin supplementation as an adjunct therapy in delaying the disease progression are needed.

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