甲状腺激素与急性心肌梗死后心功能的恢复：关联很强？

Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: a strong association?

机构信息

Department of Pharmacology, University of Athens, 75 Mikras Asias Avenue, 11527 Goudi, Athens, Greece.

出版信息

Eur J Endocrinol. 2011 Jul;165(1):107-14. doi: 10.1530/EJE-11-0062. Epub 2011 Apr 13.

DOI:10.1530/EJE-11-0062

PMID:21490121

Abstract

OBJECTIVE

This study investigated whether changes in thyroid hormone (TH) in plasma are associated with the recovery of cardiac function in patients with acute myocardial infarction (AMI). Previous experimental studies have provided evidence of potential implication of TH signaling in post-ischemic recovery of cardiac function.

METHODS

A total of 47 patients with AMI and early reperfusion therapy were included in this study. Myocardial injury was analyzed by peak creatinine kinase-MB (CKMB) and cardiac function was assessed by echocardiographic left ventricular ejection fraction (LVEF%). Recovery of function (ΔEF%) was estimated as the difference of LVEF% between 48 h and 6 months (6 mo) after AMI. Total triiodothyronine (T(3)), thyroxine (T(4)), and TSH were measured in plasma at different time points (24 h, 48 h, 5 d, and 6 mo).

RESULTS

A significant correlation between LVEF% and T(3) (r=0.5, P=0.0004) was found early after AMI (48 h), whereas no correlation was observed between CKMB and T(3) (r=-0.04, P=0.81). A strong correlation was found between ΔEF% and total T(3) (r=0.64, P=10(-6)) at 6 mo after AMI. Furthermore, multivariate regression analysis revealed that T(3) at 6 mo (r=0.64, r(2)=0.41, P=10(-6)) was an independent determinant of ΔEF%.

CONCLUSION

Changes in T(3) levels in plasma are closely correlated with the early and late recovery of cardiac function after AMI. T(3) levels at 6 mo appear to be an independent predictor of late functional recovery.

摘要

目的

本研究旨在探讨血浆中甲状腺激素（TH）的变化是否与急性心肌梗死（AMI）患者心功能的恢复有关。先前的实验研究已经提供了 TH 信号在缺血后心功能恢复中的潜在作用的证据。

方法

本研究共纳入 47 例 AMI 患者及早期再灌注治疗患者。通过峰值肌酸激酶同工酶-MB（CKMB）分析心肌损伤，通过超声心动图左心室射血分数（LVEF%）评估心功能。通过 AMI 后 48 小时和 6 个月（6 个月）之间 LVEF%的差异估计功能恢复（ΔEF%）。在不同时间点（24 小时、48 小时、5 天和 6 个月）测量血浆中的总三碘甲状腺原氨酸（T(3)）、甲状腺素（T(4)）和 TSH。

结果

AMI 后早期（48 小时）发现 LVEF%与 T(3)之间存在显著相关性（r=0.5，P=0.0004），而 CKMB 与 T(3)之间无相关性（r=-0.04，P=0.81）。在 AMI 后 6 个月时，ΔEF%与总 T(3)之间存在强烈相关性（r=0.64，P=10(-6)）。此外，多元回归分析显示，6 个月时的 T(3)（r=0.64，r(2)=0.41，P=10(-6)）是 ΔEF%的独立决定因素。