心脏再同步治疗对甲状腺功能的影响。
Effect of cardiac resynchronization therapy on thyroid function.
机构信息
Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
出版信息
Clin Cardiol. 2011 Nov;34(11):703-5. doi: 10.1002/clc.20952. Epub 2011 Sep 1.
BACKGROUND
Heart failure patients frequently have thyroid function abnormalities. Cardiac resynchronization therapy (CRT) is a major treatment for patients with advanced chronic heart failure. We aimed to investigate the effects of CRT on thyroid functions.
HYPOTHESIS
CRT improves thyroid functions.
METHODS
Fifty-seven patients (42 male, 15 female; mean age 58 ± 13 y) undergoing CRT were included in the study. Serum levels of thyroid hormones and echocardiographic parameters were measured before and 6 months after CRT. A response to CRT was defined as a reverse remodeling detected by a relative increase of ≥15% in left ventricular ejection fraction.
RESULTS
The clinical status and functional capacity of the patients in the remodeling group were improved significantly. The mean New York Heart Association class was reduced from 3.2 ± 0.4 to 2.2 ± 0.4 (P<0.001). The free triiodothyronine (fT3) level increased from 2.67 pg/mL to 2.97 pg/mL in the reverse remodeling group (P = 0.005). The fT3/fT4 ratio increased from 1.81 to 2.34 (P = 0.006).
CONCLUSIONS
CRT improves fT3 levels and fT3/fT4 ratio, which may play an important role in reverse remodeling.
背景
心力衰竭患者常伴有甲状腺功能异常。心脏再同步治疗（CRT）是治疗晚期慢性心力衰竭患者的主要方法。我们旨在研究 CRT 对甲状腺功能的影响。
假设
CRT 可改善甲状腺功能。
方法
本研究纳入了 57 名（42 名男性，15 名女性；平均年龄 58 ± 13 岁）接受 CRT 的患者。在 CRT 前和 6 个月后测量血清甲状腺激素水平和超声心动图参数。将 CRT 反应定义为通过左心室射血分数相对增加≥15%检测到的逆重构。
结果
重构组患者的临床状况和功能能力显著改善。纽约心脏协会（NYHA）分级平均从 3.2 ± 0.4 降至 2.2 ± 0.4（P<0.001）。在逆重构组中，游离三碘甲状腺原氨酸（fT3）水平从 2.67 pg/mL 增加到 2.97 pg/mL（P = 0.005）。fT3/fT4 比值从 1.81 增加到 2.34（P = 0.006）。
结论
CRT 可改善 fT3 水平和 fT3/fT4 比值，这可能在逆重构中发挥重要作用。
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