Prevalence of Thiamine Deficiency in Chronic Heart Failure Patients: Ramathibodi Cardiology Clinic Experience

Abstract

Objective: Thiamine deficiency is still a public health concern in developing countries including Thailand. Heart failure is associated with thiamine deficiency especially in patients receiving diuretic therapy. Therefore, we sought to find the prevalence of thiamine deficiency in chronic heart failure outpatients. Materials and Methods: A cross-sectional descriptive epidemiological study in 50 heart failure patients scheduled for regular follow-up visits at Ramathibodi Cardiology Clinic, Mahidol University, Bangkok, Thailand. Thiamine pyrophosphate effect was used to identify thiamine deficiency. Review of electrical medical records were made in order to collect variable clinical and demographic data. Results: The mean age was 60±2.1 years, 54% were male. The mean left ventricular ejection fraction was 37±2.5%. The prevalence of thiamine deficiency in a chronic heart failure outpatient was 6% (n=3). Thiamine status was negatively associated with left ventricular ejection fraction (r=-0.283, p=0.047) and thiamine status was positively associated with left ventricular dimension (r=0.462, p=0.001). However, there was no association between the dose of diuretic and thiamine status (r=0.024, p=0.882), duration of heart failure and thiamine status (r=-0.012, p=0.945). In patients with severe thiamine deficiency, there were subsequent serious adverse cardiovascular outcomes (one had cardiac arrest and underwent left ventricular assist device). Conclusion: We found that the prevalence of thiamine deficiency in chronic heart failure outpatients is low in an urban outpatient setting.