Current aspects of thiamine deficiency on heart function
Danilo Roman-Campos1, Jader Santos Cruz2
1Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Insights
Thiamine deficiency (TD) causes heart problems, and diagnosis is challenging due to non-specific symptoms. Younger rats show human-like TD symptoms, suggesting age impacts disease presentation.
Area of Science:
- Cardiology
- Nutritional Science
- Animal Models
Background:
- Thiamine deficiency (TD) can cause heart failure, particularly in individuals with chronic alcohol consumption.
- Diagnosing TD is difficult due to non-specific symptoms, often requiring a response to thiamine infusion for confirmation.
- Furosemide administration in heart failure patients may exacerbate TD, though existing literature presents contradictory findings.
Purpose of the Study:
- To clarify the contradictory literature regarding furosemide's impact on TD and heart failure.
- To investigate the utility of rat models in studying TD, focusing on age-related differences.
- To understand the mechanisms behind TD-induced cardiac myocyte dysfunction and its reversibility.
Main Methods:
- Review and analysis of existing literature on thiamine deficiency, heart failure, and furosemide.
- Comparative analysis of TD symptoms in human patients and animal models.
- Investigation of cardiac myocyte function in young versus aged rat models of TD.
Main Results:
- Diagnosing TD is complex, often relying on symptom resolution after thiamine administration.
- Younger rats exhibit TD symptoms more closely resembling those in humans compared to older rats.
- TD in younger rats is linked to cardiac myocyte dysfunction that improves with thiamine supplementation.
Conclusions:
- TD diagnosis requires careful clinical evaluation and response to treatment.
- Younger rats represent a more consistent model for studying human-like TD cardiac manifestations.
- Further research is needed to elucidate why only younger rats develop human-like TD symptoms.
Abstract:
Beriberi is a disease caused by thiamine deficiency (TD), which may lead to heart problems, including heart failure. Despite the fact that thiamine prevalence is reduced in the industrialized world, it remains a health hazard especially due to chronic alcohol consumption. Diagnosing the presence of TD based on both electrocardiogram and echocardiogram exams is particularly challenging because of its non-specific symptoms. TD diagnosis is unique, which then leads to determination of its severity. If thiamine infusion abrogates its symptomology, only then can the case be definitely diagnosed as TD. Another condition eliciting increased likelihood of developing TD in humans is furosemide administration to heart failure patients. Furosemide administration worsens heart failure due to heightened TD. However, literature data provided are contradictory and require clarification. Up until now, the rat has been the preferred TD animal model. However, the results are even more contradictory than those in humans. It seems that if the rat TD models are separated into two distinct groups, according to animal age, the results appear to be more consistent: younger rats are more prone to develop TD signs similar to those found in humans. Their symptoms stem from changes in cardiac myocyte function that are reversed after thiamine supplementation. However, it remains an open question as to why only younger rats are able to develop human-like symptoms and deserve further investigation.
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