The reverse triiodothyronine and heart failure
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 1
Abstract
Objective — to investigate the effects of high levels of reversible triiodothyronine (T3r) on the course of heart failure (HF). Materials and methods. The examinations involved 221 patients with HF against the background of postinfarction cardiosclerosis. The investigations included determinations of the serum levels of thyroid stimulating hormone (TSH), free (T3 (T3fr)) and thyroxin (T4 (T4fr)), reversible T3 (T3r), echocardioscopy and study of the HF course. Results and discussions. The HF patients were divided into 2 groups according to the following criterion: the first group included 175 (79.19 %) patients with normal serum T3r (< 350 pg/ml). The second group included 46 (20.81 %) patients with a high level of this hormone ≥ 350 pg/ml. In patients with HF and with a high level of T3r II functional class (FC) by NYHA HF was 30 % more often compared to frequency in patients with normal level of the hormone (c2 = 7.711, p = 0.021); nontoxic goiter (0 vs. 8.0 %, at c2 = 3.953, p = 0.047). These patients had an increased level of granulocytes (5.3 %, p = 0.043), decreased relative levels of monocytes (7.14 %, p = 0.003); increased content of TSH (35.0 %, p = 0.001) was also found, with a concordant increase in T4fr (17.0 %, p = 0.002) and T3fr (11.7 %, p = 0.041). These patients also had a lower left ventricular ejection fraction (5.26 %, p = 0.037), a thinner interventricular sept (2.5 %, p = 0.007), increased left (2.22 %, p = 0.007) and right (at 1.86 %, p = 0.003) atrium size, compared to those values in patients with normal levels of reversible triiodothyronine. The serum T3r level had a positive relationship with the presence of atrial fibrillation (r = 0.176, p = 0.028), with a relative granulocytes’ levels (r = 0.363, p < 0.001); negative with thickness of the interventricular sept in diastole (r = –0.169, p = 0.048), with relative monocyte levels in blood (r = –0.204, p = 0.018). The model of high T3r level for HF included: FC HF (a = 0.160, p = 0.008), free T3 level (a = 0.095, p = 0.009), age of the first MI development (a = 0.012, p = 0.026). Conclusions. The increased T3r level was revealed in 20.8 % of HF patients with at hospitalization. The patients with increased T3r level had significantly increased granulocytes (by 5.3 %), decreased relative monocytes’ levels (by 7.1 %), increased TSH levels (by 35.0 %) with concordant increasing of T4fr (on 17.0 %) and T3fr (by 11.7 %). Besides, they demonstrated smaller ejection fraction of the left ventricle (5.26 %), decreased size of the left (2.22 %) and right (1.86 %) atriums. The serum T3r level had a positive correlation with the presence of atrial fibrillation (r = 0.176, p = 0.028) and relative granulocytes’ levels (r = 0.363, p < 0.001); negative correlation with the thickness of the interventricular sept in diastole (r = –0.169, p = 0.048), and with the relative blood monocytes’ levels (r = –0.204, p = 0.018). The regressive model of the high T3fr levels included the following parameters: HF FC (a = 0.160, p = 0.008), T3r level (a = 0.095, p = 0.009), and age of the first myocardial infarction (a = 0.012, p = 0.026).
Authors and Affiliations
S. M. Pyvovar, Yu. S. Rudyk, O. B. Krotova
Keywords
Related Articles
- EP ID EP583584
- DOI 10.30978/UTJ2019-1-63
- Views 109
- Downloads 0
The circadian rhythms of 6-Sulfatoxymelatonin urine excretion in patients with knee osteoarthrosis
Оbjective — to establish the peculiarities of the circadian rhythms of 6-sulfatoxymelatonin (6-SMT) urine excretion in patients with knee osteoarthrosis (OA) depending on age, gender, duration and stage of the disease. M...
The syndrome of «Low triiodothyronine» and its frequency at the heart failure
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 investigatio...
The peculiarities of liver damage markers and lipid blood spectrum in patients with nonalcoholic steatohepatitis, osteoarthritis and obesity
Objective — to reveal the peculiarities of the course of nonalcoholic steatohepatitis (NASH) in comorbidity with osteoarthritis (OA) and obesity (OB) based on the study the blood lipid profile effects on the diseases’ co...
The reverse triiodothyronine and heart failure
Objective — to investigate the effects of high levels of reversible triiodothyronine (T3r) on the course of heart failure (HF). Materials and methods. The examinations involved 221 patients with HF against the background...
Influence of the tobacco smoking factor in the comorbid course of chronic obstructive pulmonary disease and ischemic heart disease
Objective — to assess the clinical state, external respiration, structural and functional state of the heart and blood vessels, blood levels of NT-proBNP and factors of the systemic inflammatory response in patients with...