Reduced thiamine phosphate, but not thiamine diphosphate, in erythrocytes in elderly patients with congestive heart failure treated with furosemide

Objectives. To measure the concentrations of thiamine and thiamine esters b y high-pressure liquid chromatography (HPLC) in elderly patients treated wi th furosemide for heart failure and in a control group. Design. A cross-sectional study of blood thiamine and thiamine ester concen trations. Subjects. Forty-one patients admitted to hospital for heart failure and 34 elderly living at home. No vitamin supplementation was allowed. Results. Compared with the healthy controls, furosemide-treated patients ha d significantly reduced whole blood thiamine phosphate (TP; 4.4 +/- 2.2 vs. 7.6 +/- 2.0 nmol L-1) and thiamine diphosphate (TPP; 76 +/- 21.5 vs. 91 +/ - 19.8 nmol L-1) (mean +/- SD). When the thiamine concentrations were relat ed to the haemoglobin concentrations, which were reduced in the heart failu re patients, the levels of TP (nmol g(-1) Hb) were 0.38 +/- 0.26 vs. 0.54 /- 0.17 (P < 0.0001), and of TPP were 6.35 +/- 1.76 vs. 6.37 +/- 1.29 (P = 0.95). There were no differences in T and TP concentrations in plasma betwe en the two groups. Conclusions. The elderly patients with heart failure treated with furosemid e have not reduced the storage form of thiamine, TPP, but only TP. This cha nge is most likely not an expression of a thiamine deficiency, but rather o f an altered metabolism of thiamine, which is not understood at present.