Meng X B, Wang W Y, Zhang K, Qi Y, An S M, Wang S Y, Zheng J L, Yu Q J, Tang B, Wu R, Gao C Y, Wang S Y, Tang Y D
Department of Internal Medicine, Coronary Heart Disease Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China.
Zhonghua Nei Ke Za Zhi. 2018 Apr 1;57(4):258-263. doi: 10.3760/cma.j.issn.0578-1426.2018.04.006.
To determine whether thyroid hormone (TH) level could also be an independent and incremental predictor of adverse events in patients with hypertrophic cardiomyopathy (HCM). A total of 982 consecutive patients with HCM at the National Center for Cardiovascular Diseases (China) from October 2009 to December 2013 were included in the present study, and followed up till the end of December 2016. The patients were divided into three groups according to the levels of free triiodothyronine (FT): the group 1 (FT≤4.28 pmol/L, 335), the group 2 (FT>4.28-<4.79 pmol/L, 310), and the group 3 (FT 4.79-6.30 pmol/L, 337). After a follow-up period of (53.8±14.1) months, 39 patients (4.0%) either suffered death with all causes or received a cardiac transplantation (7.8%, 2.9% and 1.2% of the patients in the group 1, group 2 and group 3, respectively). A multivariable Cox regression analysis revealed that FT≤4.28 pmol/L was associated with a significantly higher risk of all-cause mortality or cardiac transplantation ( 8.83, 95% 1.115- 69.905,0.039) in HCM patients. Low levels of FT is a risk factor of adverse events for patients with HCM, indicting a role of FT as a marker for assessing the risk of long-term adverse events in these patients.
为了确定甲状腺激素（TH）水平是否也能成为肥厚型心肌病（HCM）患者不良事件的独立且递增的预测指标。本研究纳入了2009年10月至2013年12月在中国国家心血管病中心连续收治的982例HCM患者，并随访至2016年12月底。根据游离三碘甲状腺原氨酸（FT）水平将患者分为三组：第1组（FT≤4.28 pmol/L，335例）、第2组（FT>4.28-<4.79 pmol/L，310例）和第3组（FT 4.79-6.30 pmol/L，337例）。经过（53.8±14.1）个月的随访期后，39例患者（4.0%）出现全因死亡或接受心脏移植（第1组、第2组和第3组患者分别占7.8%、2.9%和1.2%）。多变量Cox回归分析显示，FT≤4.28 pmol/L与HCM患者全因死亡或心脏移植的风险显著升高相关（8.83，95%置信区间1.115-69.905，P=0.039）。低水平的FT是HCM患者不良事件的危险因素，表明FT可作为评估这些患者长期不良事件风险的标志物。
