Rothberger Gary D, Gadhvi Sonya, Michelakis Nickolaos, Kumar Amit, Calixte Rose, Shapiro Lawrence E
Division of Endocrinology, Winthrop-University Hospital, Mineola, New York.
Division of Cardiology, Winthrop-University Hospital, Mineola, New York.
Am J Cardiol. 2017 Feb 15;119(4):599-603. doi: 10.1016/j.amjcard.2016.10.045. Epub 2016 Nov 16.
Thyroid hormone plays an important role in cardiac function. Low levels of serum triiodothyronine (T) due to nonthyroidal illness syndrome may have adverse effects in heart failure (HF). This study was designed to assess the ability of T to predict in-hospital outcomes in patients with acute HF. In total, 137 patients without thyroid disease or treatment with drugs which affect TH levels, who were hospitalized with acute HF were prospectively enrolled and studied. TH levels were tested upon hospital admission, and outcomes were compared between patients with low (<2.3 pg/ml) and normal (≥2.3 pg/ml) free T levels as well as between those with low (<0.6 ng/ml) and normal (≥0.6 ng/ml) total T levels. Low free T correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and higher rates of intensive care unit admission (31.8% vs 16.9%, p = 0.047), with a trend toward increased need for invasive mechanical ventilation (9.0% vs 1.4%, p = 0.056). Low total T3 correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and increased need for invasive mechanical ventilation (9.8% vs 1.3%, p = 0.045). In conclusion, low T predicts worse hospital outcomes in patients with acute HF and can be useful in the risk stratification of these patients.
甲状腺激素在心脏功能中起着重要作用。非甲状腺疾病综合征导致的血清三碘甲状腺原氨酸（T3）水平降低可能对心力衰竭（HF）产生不利影响。本研究旨在评估T3预测急性HF患者住院结局的能力。总共前瞻性纳入并研究了137例无甲状腺疾病或未接受影响甲状腺激素水平药物治疗、因急性HF住院的患者。入院时检测甲状腺激素水平，并比较游离T3水平低（<2.3 pg/ml）和正常（≥2.3 pg/ml）的患者以及总T3水平低（<0.6 ng/ml）和正常（≥0.6 ng/ml）的患者之间的结局。游离T3水平低与住院时间延长（中位数11天对7天，p<0.001）和重症监护病房入住率较高（31.8%对16.9%，p = 0.047）相关，有创机械通气需求增加的趋势（9.0%对1.4%，p = 0.056）。总T3水平低与住院时间延长（中位数11天对7天，p<0.001）和有创机械通气需求增加（9.8%对1.3%，p = 0.045）相关。总之，T3水平低可预测急性HF患者更差的住院结局，对这些患者的风险分层可能有用。
