The syndrome of «Low triiodothyronine» and its frequency at the heart failure
Journal Title: Український терапевтичний журнал - Year 2018, Vol 0, Issue 1
Abstract
Objective — to study the frequency of the «Low triiodothyronine (T3)» syndrome in patients with decompensated heart failure (HF) on admission and its effects on the disease course. Materials and methods. The investigation involved 188 patients with HF against the background of postinfarction cardiosclerosis (73 women and 115 men). The level of free T3 (T3f) < 2.0 pg/ml, with normal TSH and T4f was sued as a criterion the «Low T3» syndrome. On admission, the patients underwent the standardized assessment, including a detailed medical history (concomitant diseases and medications), physical examination, parameters of clinical and biochemical blood tests, 12-lead electrocardiogram. A standardized ultrasound heart investigation was performed with calculations of the LV ejection fraction (EF) and LV dimensions. The serum level of hormones (TTG, free T3 and free T4) were determined using reagent kits (DS-IFA-Tyroid). NT-proBNP in the blood serum was assessed by an enzyme immunoassay using Insulin ELISA reagent kits (DRG Instruments GmbH, Germany). The optical density was measured and the results were calculated by a semiautomatic immunoassay analyzer Immunochem 2100 (USA). Results and discussion. The established frequency of the «Low T3» syndrome among patients with heart failure on admission was 27.7%. In patients with HF against the background of postinfarction cardiosclerosis, the natriuretic peptide is in a weak direct correlation with the frequency of the «Low T3» syndrome (r = +0.23, p < 0.05) and in the reverse (medium degree) with serum free triiodothyronine (T3f) (r = –0.46, p < 0.05). Patients with the HF course against the background of the «Low T3» syndrome in comparison with patients without peripheral dysthyroidism, the following indices were established on admission: the LVEF lower by 10.5 % (p < 0.05); the final diastolic LV size higher by 5.7 % (p < 0.05) and heart rate higher by 14.3 % (p < 0.05), the glomerular filtration rate lower by 10.6 % (p < 0.05) and the blood hemoglobin level lower by 6.5 % (p < 0.05). Conclusions. The frequency of the «Low T3» syndrome at HF is 27.7 %. At HF, the natriuretic peptide levels had a weak direct correlation with the frequency of the «Low T3» syndrome and reverse correlation with the T3f level. On admission, the patients with HF had the lower LVEF indices, higher final diastolic LV size and heart rate; less glomerular filtration rate and hemoglobin level of blood.
Authors and Affiliations
S. M. Pyvovar
Keywords
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