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Am J Med. 2016 Jul;129(7):753.e7-753.e11. doi: 10.1016/j.amjmed.2016.01.037. Epub 2016 Feb 18.

Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review.

Author information

1
Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia.
2
Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia. Electronic address: alpertm@health.missouri.edu.

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.

KEYWORDS:

Furosemide; Heart failure; Thiamine; Thiamine deficiency

PMID:
26899752
DOI:
10.1016/j.amjmed.2016.01.037
[Indexed for MEDLINE]

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