Vicious cycle of vitamin Bi insufficiency and heart failure in cardiology outpatients

Heart failure is a major manifestation of vitamin B(1 )deficiency; beriberi. We have previously reported that even vitamin B-1 insufficiency, milder than deficiency, is a risk for heart failure in the institutionalized elderly. Then in this cross-sectional study, sixty-eight cardiology outpatients were evaluated for their whole blood vitamin B-1 and plasma bram natriuretic peptide (BNP) concentrations, a sensitive marker of heart failure, as well as their dietary intake. Whole blood vitamin B(1 )concentration was significantly correlated with plasma BNP level in vitamin B-1 deficient/insufficient patients (whole blood vitamin B-1<28ng/mL) but not in sufficient patients. Whole blood vitamin B-1 concentration was significantly lower in loop diuretics users than non-users. Multiple regression analysis has identified whole blood vitamin B-1 concentration and eGFR as the significant contributors to logtransformed plasm BNP level, and loop diuretics use, serum albumin level, and eGFR as the contributors to whole blood vitamin B(1 )concentration. ROC analysis has shown the significant predictability of whole blood vitamin B-1 for plasma BNP 100pg/mL with the cut-off value of 23.5ng/mL. Vitamin B-1 insufficiency is a risk of heart failure in the cardiology outpatients, and the therapeutic use of loop diuretics aggravates heart failure and possibly forms a vicious cycle.