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Titolo:
SICK EUTHYROID SYNDROME IN PATIENTS WITH MODERATE-TO-SEVERE CHRONIC HEART-FAILURE
Autore:
OPASICH C; PACINI F; AMBROSINO N; RICCARDI PG; FEBO O; FERRARI R; COBELLI F; TAVAZZI L;
Indirizzi:
CTR MED MONTESCANO,DIV CARDIOL,HEART FAILURE UNIT I-27040 MONTESCANO PV ITALY UNIV PISA,INST ENDOCRINOL I-56100 PISA ITALY
Titolo Testata:
European heart journal
fascicolo: 12, volume: 17, anno: 1996,
pagine: 1860 - 1866
SICI:
0195-668X(1996)17:12<1860:SESIPW>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
THYROID-HORMONE METABOLISM; ATRIAL NATRIURETIC PEPTIDE; NONTHYROIDAL ILLNESSES; THYROXINE; TRIIODOTHYRONINE; HYPOTHYROIDISM; PERFORMANCE; CONVERSION;
Keywords:
THYROID FUNCTION; CHRONIC HEART FAILURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
C. Opasich et al., "SICK EUTHYROID SYNDROME IN PATIENTS WITH MODERATE-TO-SEVERE CHRONIC HEART-FAILURE", European heart journal, 17(12), 1996, pp. 1860-1866

Abstract

Background Changes in peripheral thyroid hormone concentration and metabolism can occur in euthyroid patients suffering from severe non-thyroidal illnesses. Recently, sick euthyroid syndrome has been reported in patients suffering from advanced heart failure. Aim This study was to evaluate prospectively the presence and pathophysiological implications of sick euthyroid syndrome in moderate-to-severe chronic heart failure patients. Methods The study population were 199 chronic heart failure patients admitted over a 2-year period to our heart failure unitfor assessment of cardiac transplantation. They were closely followedup with clinical and instrumental examinations (including clinical, hormonal, nutritional and cardiac function evaluations). Sick euthyroidsyndrome was defined as a serum total triiodothyronine value of less than the lowest normal limit (<1.23 nmol . l(-1)) in the presence of anormal serum thyroid stimulating hormone concentration. Results Sick euthyroid syndrome was found in 36/199 patients (18%). According to the New York Heart Association (NYHA) classification of severity of heart failure, sick euthyroid syndrome patients appear in higher NYHA classes (31% of classes III and IV, vs 7% of class I and II). Such patients also weigh less and are more frequently malnourished. Alterations incardiac index, ventricular filling pressures, functional impairment, and the liver function parameters, were more significant in sick euthyroid syndrome than in non-sick euthyroid syndrome patients. Serum norepinephrine and atrial natriuretic factor were significantly higher, and insulin significantly lower in the sick euthyroid syndrome group. During follow-up, deaths were significantly more frequent in sick euthyroid syndrome patients (13/27, 48%) than in non-sick euthyroid syndrome(30/141, 21%; P<0.005). In six sick euthyroid syndrome patients who underwent heart transplantation, mean total triiodothyronine values increased from 0.9 +/- 0.1 before to 1.96 +/- 0.3 nmol.l(-1) post-transplantation (P<0.05). Conclusions In a large and representative population of patients with moderate-to-severe heart failure, sick euthyroid syndrome shows a prevalence of 18%. Its occurrence was related to the degree of functional cardiac impairment, but was not an independent negative prognostic factor. Preliminary results indicate that heart transplantation is associated with reversibility of sick euthyroid syndrome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 06:37:39