心臓と肺のリハビリテーションのジャーナル

抽象的な

Thiamine Deficiency and Prolonged Hospitalization in Elderly Patients with Heart Failure

Takaya Naraoka, Junko Morimoto, Akira Taruya, Yoshinori Asae, Kazuya Mori, Takahiro Nishi, Motoki Taniguchi, Keisuke Satogami, Atsushi Tanaka

Objective: Thiamine plays a key role in carbohydrate and branched fatty acid metabolism, and its deficiency causes heart failure and muscle weakness. Thiamine deficiency is frequently found in patients with heart failure, ranging from 21% to 98% of patients with heart failure, because of the low nutritional status associated with old age and upregulated thiamine excretion due to diuretic use. This study investigated the relationship between thiamine deficiency, muscle weakness, and the hospitalization period in elderly patients with heart failure.

Methods: This study included 73 consecutive elderly patients (>65 years) with heart failure who underwent a standard cardiac rehabilitation program at the Arida Municipal Hospital. Serum thiamine levels were measured upon admission. The patients were classified into normal VB1 and low VB1 groups according to serum thiamine levels using a 28 ng/mL cut-off. We compared patient backgrounds, echocardiography data, nutrition, days to walk 10m, and hospitalization periods between the two groups.

Results: Thiamine deficiency was observed in 49 (67%) patients. The two groups had no significant differences in age, sex, body mass index, New York Heart Association classification, B-type natriuretic peptide levels, and left ventricular ejection fraction. More days were needed to walk 10m again in the low group than in the normal group (low VB1 33 [6–245] days vs. normal VB1 4.5 [2–12.8] days, p<0.01). The duration of hospitalization was longer in the low group than in the normal group (low VB1 53 [27–68] days vs. normal VB1 21 [16–28] days, p<0.01).

Conclusions: Thiamine deficiency is associated with muscle weakness and prolonged hospitalization in elderly patients with heart failure. Irrespective of the cause or result of heart failure, our results suggest that thiamine deficiency is associated with the prognosis of heart failure. More attention should be paid to thiamine deficiency in elderly patients with heart failure.