The effects of thiamine supplementation on patients with heart failure: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Micronutrients can benefit patients with heart failure (HF). Thiamine is a critical vitamin, while the impact of thiamine supplementation on patients with HF remains unclear. Systematic review and meta-analysis were conducted to evaluate the effects of thiamine supplementation on clinical outcomes in patients with HF. METHODS: Databases including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Scopus, and CNKI were searched from inception to June 29th 2022. Randomized controlled trials (RCTs) comparing thiamine supplementation with placebo were included. Meta-analysis was conducted with the software Review Manager 5.4. The quality assessment was performed according to Cochrane Risk of Bias Tool 2.0. RESULTS: Eight studies including 384 patients were included in this review. The results of overall systematic review showed no benefit of thiamine supplementation in HF patients. Compared with the control group, the experimental group had no statistically significant improvements in LVEF (Mean Difference, - 0.19; 95 % CI, - 2.78 to 0.96; I2 = 49 %; P = 0.10) in patients with chronic heart failure (CHF). Other outcomes including NYHA class, BNP or NT-proBNP, thiamine status, symptom changes, and quality of life were not improved by thiamine supplementation in CHF patients. Similarly, no improvements in clinical outcomes were found in patients with acute heart failure (AHF) in the studies included. CONCLUSIONS: This systematic review and meta-analysis found no evidence to support the effects of thiamine supplementation in patients with HF, though thiamine supplementation is promising in improving cardiac functions, thiamine status and relieving HF-related symptoms. More well-designed RCTs with large sample sizes are required.

Thirst and factors associated with thirst in hospitalized patients with heart failure in China.

BACKGROUND: Thirst is a distressing symptom and increases burden of the patients with heart failure (HF). Knowledge about thirst in HF patients is still not clear in China. OBJECTIVE: To describe thirst intensity, distress, frequency, and duration and to identify factors associated with thirst intensity in hospitalized HF patients in China. METHODS: A cross-sectional descriptive study was conducted in two public hospitals in Shanghai, China. Patients were recruited in cardiology wards. Sociodemographic and clinical data were collected by the social-demographic and disease-related questionnaire. Thirst was assessed by Visual Analog Scale (VAS, 0-100 mm), Thirst Distress Scale for HF patients (scores 8 to 40) and three questions about thirst frequency and duration. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. RESULTS: Four hundred and thirty-one patients participated in this study. Their mean (SD) thirst intensity was 47 (±22) mm, and the thirst distress was 21(±4). It was found that 75% patients had moderate to severe feeling in thirst intensity and 73% in distress. Most patients experienced thirst several times a week (33%) or several times a month (38%). Most patients (88%) felt thirst for one hour or less. The most intense thirst occurred in the morning (26%), afternoon (19%) and before sleeping (16%). Factors associated with thirst were omeprazole, renal insufficiency, coronary heart disease, high NYHA class and low room humidity. No links were found between physiological indicators of HF (ProBNP) and thirst. CONCLUSIONS: HF patients have strong sense of thirst. However, it is rarely identified by healthcare professionals. It is crucial for healthcare providers to keep an eye on patients' thirst symptoms. More attention should be paid to patients with thirst risk factors to minimize the discomfort of thirst.