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The Prevalence of Thiamin Deficiency in Hospitalized Patients With Congestive Heart Failure

Stacy A. Hanninen, RD, MSc^_*,, Pauline B. Darling, PhD, RD^,, Michael J. Sole, MD, FRCPC, FACC^||,_**, Aiala Barr, PhD^¶ and Mary E. Keith, PhD^,#,_*

^_* Heart and Vascular Program
Department of Nutrition
Division of Cardiovascular and Thoracic Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
Department of Nutritional Sciences
^|| Heart and Stroke/Richard Lewar Centre of Excellence
^¶ Department of Public Health
^# Department of Surgery, University of Toronto, Toronto, Ontario, Canada
^_** Division of Cardiology, University Health Network, Toronto, Ontario, Canada

View larger version (19K): [in a new window]   Figure 1 The distribution of erythrocyte thiamin pyrophosphate (TPP) in congestive heart failure (CHF) patients by grade of left ventricular function. Grade 1 or 2 = ejection fraction (EF) >35%, grade 3 or 4 = EF <35%. The dashed line is drawn at an erythrocyte TPP of 78 ng/ml packed red blood cells (RBCs). Congestive heart failure patients with a TPP below this cut point were considered thiamin deficient (TD).

View larger version (14K): [in a new window]   Figure 2 The distribution of erythrocyte TPP in healthy control patients. The dashed line is drawn at TPP of 78 ng/ml packed RBCs. Controls with TPP values below this cut point were considered TD. Abbreviations as in Figure 1.

View larger version (16K): [in a new window]   Figure 3 The distribution of erythrocyte TPP in CHF patients according to use of thiamin-containing multivitamins. The dashed line is drawn at an erythrocyte TPP of 78 ng/ml packed RBCs. Congestive heart failure patients with a TPP below this cut point were considered TD. Abbreviations as in Figure 1.

View larger version (22K): [in a new window]   Figure 4 The distribution of urinary losses of thiamin per gram of creatinine by left ventricular (LV) function grade. Grade 1 or 2 = EF >35%, grade 3 or 4 = EF <35%. The dashed line indicates urine thiamin loss of 66 µg/g creatinine, the level above which has been proposed to represent normal urinary thiamin excretion (2).

View larger version (12K): [in a new window]   Figure 5 The relationship between estimated daily intake of thiamin (mg) and total urine thiamin (µg/day).