Role of Thiamine in Pediatric CHD: Effects on LV Function and MMP-9/TIMP-1

Congenital Heart Disease (CHD) represents the predominant form of congenital anomaly and occurs in approximately 0.8% of live births. Surgical correction is the definitive method used to treat CHD; however, postoperative complications can increase the risk of mortality and morbidity. Transcatheter closure has emerged as an alternative therapy for some CHD with left-to-right shunts, providing outcomes comparable with those of surgical correction. This narrative review was conducted to synthesize existing literature on the effect of thiamine supplementation in pediatric patients undergoing transcatheter closure for left-to-right shunt CHD. Thiamine deficiency in pediatric heart disease can weaken the heart by reducing its energy supply. Conversely, harmful changes to the heart's structure are linked to a specific enzyme balance. Since evidence suggests thiamine can correct this imbalance, thiamine supplementation may represent a therapeutic strategy to improve heart structure and function after treatment. In individuals with systolic heart failure, supplementation with thiamine has been associated with an enhancement in Left Ventricular Ejection Fraction (LVEF). Thiamine acts directly on cardiomyocytes, enhancing energy production and improving cardiac function. Therefore, thiamine administration during transcatheter closure is expected to stabilize the Matrix Metalloproteinase- 9 (MMP-9) and Tissue Inhibitor of Metalloproteinase-1 (TIMP-1) levels, which may enhance or improve left ventricular function and dimensions.