Triiodothyronine levels for risk stratification of patients with chronic heart failure

Pingitore, Alessandro; Landi, Patrizia; Taddei, Marco; Ripoli, Andrea; LʼAbbate, Antonio; Iervasi, Giorgio

doi:10.1016/j.amjmed.2004.07.052

Cited by 181 publications

(130 citation statements)

References 23 publications

(22 reference statements)

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“…[107][108][109] The decrease in serum T 3 is proportional to the severity of the heart disease as assessed by the New York Heart Association functional classification. 107 The low T 3 syndrome is defined as a fall in serum T 3 accompanied by normal serum T 4 and TSH levels, and the syndrome results from impaired hepatic conversion of T 4 to the biologically active hormone, T 3 , by 5Ј-monodeiodination.…”

Section: Heart Disease and Thyroid Functionmentioning

confidence: 99%

“…12,24,25 Reduced serum T 3 is a strong predictor of all-cause and cardiovascular mortality and, in fact, is a stronger predictor than age, left ventricular ejection fraction, or dyslipidemia (Figure 4). 108 It has been suggested that physiological T 3 therapy might improve cardiac function in this clinical situation. 1…”

Section: Heart Disease and Thyroid Functionmentioning

confidence: 99%

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Thyroid Disease and the Heart

Klein¹,

Danzi²

2016

Current Problems in Cardiology

137

104

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Abstract-The cardiovascular signs and symptoms of thyroid disease are some of the most profound and clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the cellular mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure, vascular resistance, and rhythm disturbances that result from thyroid dysfunction. The importance of the recognition of the effects of thyroid disease on the heart also derives from the observation that restoration of normal thyroid function most often reverses the abnormal cardiovascular hemodynamics. In the present review, we discuss the appropriate thyroid function tests to establish a suspected diagnosis as well as the treatment modalities necessary to restore patients to a euthyroid state. We also review the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure and the approach to the management of patients with amiodarone-induced alterations in thyroid function tests.

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Section: Heart Disease and Thyroid Functionmentioning

confidence: 99%

Section: Heart Disease and Thyroid Functionmentioning

confidence: 99%

Thyroid Disease and the Heart

Klein¹,

Danzi²

2016

Current Problems in Cardiology

137

104

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“…However, effects of EECP therapy on prognostic markers of HF have not been determined in previous studies (10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

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Objective: Enhanced external counterpulsation (EECP) is a noninvasive treatment that is proven safe and effective in patients with coronary artery disease (CAD) and heart failure (HF). The aims of this study are to investigate the clinical effects of EECP therapy in patients with symptomatic CAD and chronic HF, and to find out an answer to the question: Does EECP therapy have any effect on the prognostic markers of HF? Methods: This study was designed as a prospective cohort study. A total of 68 consecutive patients with symptomatic CAD and chronic HF referred to EECP therapy were enrolled in this study between November 2007 and December 2010; 47 patients (39 males and 8 females, 65±7, years), have undergone EECP treatment, and 21 patients (20 males and 1 female, 62±10 years), who did not want to participate in the EECP program comprised the control group. Statistical analysis was performed using t tests for dependent and independent samples, Mann-Whitney U test, Chi-square and Fischer exact tests. Results: EECP therapy resulted in significant improvement in post-intervention New York Heart Association functional class (p<0.001), left ventricular ejection fraction (p<0.001), B-type natriuretic peptide levels (p<0.003), uric acid levels (p<0.05), free-T3/free-T4 ratio (p<0.034) and mitral annular E (p<0.05) velocity, compared with baseline, a finding not evident in the control group. Conclusion: EECP treatment significantly improved clinical and some biochemical parameters, which are mostly prognostic markers in patients with symptomatic CAD and chronic HF. (Anadolu Kardiyol Derg 2012; 12: 214-21)

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“…The mortality in the infarction group within the first 24 h was up to 40%. Myocardial infarctions which produced a scar area of 90-135 mm 2 were included in this study, corresponding to 35-55% of the left ventricle. The animals were left to recover for 2 or 13 weeks after myocardial infarction.…”

Section: Experimental Model Of Myocardial Infarctionmentioning

confidence: 99%

“…Altered TH pattern is evident at a very early stage of the idiopathic left ventricular dysfunction and TH levels in plasma have been closely related to cardiac dysfunction and patient symptoms (1). Furthermore, in overt heart failure, low TH levels have been associated with increased mortality (2). Accordingly, experimental studies on animals have linked changes in thyroid signalling with cardiac dysfunction due to hypertrophy or heart failure.…”

Section: Introductionmentioning

confidence: 99%

Time-dependent changes in the expression of thyroid hormone receptor α1 in the myocardium after acute myocardial infarction: possible implications in cardiac remodelling

et al. 2007

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The present study investigated whether changes in thyroid hormone (TH) signalling can occur after acute myocardial infarction (AMI) with possible physiological consequences on myocardial performance. TH may regulate several genes encoding important structural and regulatory proteins particularly through the TRa1 receptor which is predominant in the myocardium. AMI was induced in rats by ligating the left coronary artery while sham-operated animals served as controls. This resulted in impaired cardiac function in AMI animals after 2 and 13 weeks accompanied by a shift in myosin isoforms expression towards a fetal phenotype in the non-infarcted area. Cardiac hypertrophy was evident in AMI hearts after 13 weeks but not at 2 weeks. This response was associated with a differential pattern of TH changes at 2 and 13 weeks; T 3 and T 4 levels in plasma were not changed at 2 weeks but T 3 was significantly lower and T 4 remained unchanged at 13 weeks. A twofold increase in TRa1 expression was observed after 13 weeks in the non-infarcted area, P!0.05 versus sham operated, while TRa1 expression remained unchanged at 2 weeks. A 2.2-fold decrease in TRb1 expression was found in the non-infarcted area at 13 weeks, P!0.05, while no change in TRb1 expression was seen at 2 weeks. Parallel studies with neonatal cardiomyocytes showed that phenylephrine (PE) administration resulted in 4.5-fold increase in the expression of TRa1 and 1.6-fold decrease in TRb1 expression versus untreated, P!0.05. In conclusion, cardiac dysfunction which occurs at late stages after AMI is associated with increased expression of TRa1 receptor and lower circulating tri-iodothyronine levels. Thus, apo-TRa1 receptor state may prevail contributing to cardiac fetal phenotype. Furthermore, down-regulation of TRb1 also contributes to fetal phenotypic changes. a1-adrenergic signalling is, at least in part, involved in this response. 156 415-424 European Journal of Endocrinology

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Triiodothyronine levels for risk stratification of patients with chronic heart failure

Abstract: Low T(3) levels are an independent predictor of mortality in patients with chronic heart failure, adding prognostic information to conventional clinical and functional cardiac parameters.

Cited by 181 publications

References 23 publications

Thyroid Disease and the Heart

Thyroid Disease and the Heart

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Time-dependent changes in the expression of thyroid hormone receptor α1 in the myocardium after acute myocardial infarction: possible implications in cardiac remodelling

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