Thiamine Deficiency in Organic Heart Disease

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Abstract
Since cocarboxylase, derived from thiamine, is necessary for normal utilization of pyruvate by heart muscle, the importance of adequate body stores of thiamine in patients with chronic heart disease is quite obvious. In order to investigate the occurrence of subclinical thiamine deficiency in patients with chronic heart disease, the thiamine was determined in the four-hour specimen of urine after loading dose in 35 male patients with congestive heart failure and compared with thiamine excretion in 17 persons free from cardiac disease. It was found that the noncardiac group had a significantly higher excretion of thiamine after a loading dose than patients with heart disease. Nine patients with severe heart failure receiving mercurial diuretics in the course of treatment were studied using 24-hour urine collections before, during and after the injection of the mercurial. The 24-hour urinary thiamine content was measured, demonstrating significant increases in thiamine excretion with mercurial diuresis.