Mejoría de la capacidad funcional tras tratamiento con levotiroxina en pacientes con insuficiencia cardíaca crónica e hipotiroidismo subclínico

Grasiosi, Jorge Curotto; Peressotti, Bruno; Machado, Rogelio A.; Filipini, Eduardo; Angel, A.; Delgado, Jorge; Quiroga, Gustavo Aníbal Cortez; Mansilla, Carmen Rus; Quesada, María del Mar Martínez; Degregorio, Alejandro; Cordero, Diego J.; Dak, Marcelo; Izurieta, Carlos; Esper, Ricardo J.

doi:10.1016/j.endonu.2013.01.013

Cited by 11 publications

(1 citation statement)

References 30 publications

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“…Epidemiological data have revealed that approximately 13–15% of patients with HF have subclinical hypothyroidism, especially elderly patients [5–8]. Subclinical hypothyroidism (TSH 8.59 ± 4.91 mIU/L) is an independent risk factor for death (hazards ratio = 2.869, 95% confidence interval 1.817–4.532) [9].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of levothyroxine (L-T4) replacement on the exercise capability in chronic systolic heart failure patients with subclinical hypothyroidism: Study protocol for a multi-center, open label, randomized, parallel group trial (ThyroHeart-CHF)

Zhang

Wang

Zhang

et al. 2019

Trials

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Background Subclinical hypothyroidism is a common condition in patients with heart failure and is defined as elevated serum thyroid hormone (TSH) with normal circulating free thyroxine (FT4). Evidence on the effect of thyroid hormone treatment is lacking. We designed a randomized controlled trial to compare the efficacy and safety of thyroid hormone supplementation in patients with chronic heart failure complicated with subclinical hypothyroidism. Methods/design Eligible participants were identified from the cardiology units of five study centers based on the following criteria: 18 years or older, systolic heart failure with NewYork Heart Association (NYHA) class II–III, left ventricular ejection fraction ≤ 40%, and subclinical hypothyroidism (TSH > 4.78μIU/ml, < 10 μIU/ml + FT4 level within reference range). Eligible patients will be randomly assigned in a 1:1 manner to receive thyroxine replacement therapy plus standard chronic heart failure (CHF) treatment or only standard CHF therapy. Levothyroxine will be administered at an initial dose of 12.5 μg once daily and will be titrated until TSH is within the normal range. The primary endpoints include the difference in distance of the six-minute walk test between 24 weeks and baseline. The secondary endpoints include differences in plasma NT-proBNP levels and serum lipid profiles, changes in the NYHA classification, cardiovascular death, re-hospitalization, differences in echocardiographic and cardiac magnetic resonance imaging measures, and Minnesota Living With Heart Failure Questionnaire (MLHFQ) results between 24 weeks and baseline. Discussion ThyroHeart-CHF is designed as a prospective, multi-center, randomized, controlled clinical trial to study the efficacy and safety of thyroid hormone supplementation in patients with chronic heart failure complicated with subclinical hypothyroidism. The study findings will have significant implications for discovering the new therapeutic targets and methods of heart failure. Trail Registration ClinicalTrials.gov, NCT03096613 . Registered on 30 March 2017.

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Section: Introductionmentioning

confidence: 99%