Peculiarities of the heart failure course in patients with non-toxic goiter: clinical aspects
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 2
Abstract
Objective — to investigate peculiarities of the heart failure (HF) course in patients with non-toxic goiter (NG). Materials and methods. Examinations involved 222 patients with HF (with previous myocardial infarction (MI)). At admission, all patients underwent a standardized assessment of their condition, determinations of the intra-cardiac hemodynamics’ parameters, thyroid hormones’ level, clinical and biochemical blood tests. Results and discussion. According to the data of the automatic regression analysis for NG, the following variables have possible relationship in patients with HF: the frequency of re-admission for 2 years (R2 = 0.381; p = 0.0001), the presence of syndrome low T3 (SLT) (R2 = 0.141; p = 0, 0001), the presence of subclinical hypothyroidism (R2 = 0,139; p = 0,0001), HDL cholesterol level (R2 = 0,09; p = 0,004), body weight (R2 = 0,052; p = 0,028), quantity of previous MIs (R2 = 0,042; p = 0,049). The lowest frequency of re-hospitalization for 2 years was registered in patients with HF without NG (15.8 %), while among patients with HF and NG, this figure was 50 % (χ2 = 27.881; p < 0,0001). In the group of patients with HF, which runs against the NG background, the frequency of SLT was 32.1 % versus 10.6 % among patients without NG (χ2 = 11.073; p < 0.001). The highest incidence of favorable HF (absence of re-hospitalization) was observed in the group of patients without NG and without SLT (49.0 %). At the same time, when combined with both HF and NG and SLT, the likelihood of re-admission is 59.2 % (9 out of 17 patients) (χ2 = 13.271; p = 0.005). In patients with NG, a tendency towards a higher incidence of subclinical hypothyroidism (15.1 %) was observed, compared with that among patients without nontoxic goiter (5.8 %) (χ2 = 3.759; p = 0.053). The groups of patients differed in serum levels of HDL cholesterol and triiodothyronine. Thus, in the group of patients with NG, the T3F level was lower, compared with the group of patients without NG (3.15 [1.93—3.64], against 3.40 [2.62—3.77] pml/l) was 7.35 % (p = 0.048) and the higher concentration of LPHD (1.18 [1.06—1.18] versus 1.06 [1.06—1.21] mmol/l) — 11.32 % (p = 0.016). Conclusions. The results of the study demonstrated significantly higher rate of re-hospitalization during 2 years in patients with heart failure and non-toxic goiter. The reason for such unfavorable heart failure course against the background non-toxic goiter is likely associated with higher frequency of syndrome of low T3. Patients with heart failure and non-toxic goiter did not differ from those without morphological pathology of the thyroid gland by age, gender distribution and parameters of intracardiac hemodynamics.
Authors and Affiliations
S. M. Pyvovar
Keywords
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- EP ID EP624198
- DOI 10.30978/UTJ2019-2-33
- Views 85
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