664 Low T3 syndrome in chronic heart failure: relation with A- and B-type natriuretic peptide expression and prognostic value

Background: Effect of thyroid hormone on cardiac functions is mediated by biologically active T3 which binds to nuclear TR. There is increasing evidence that patients with mild thyroid dysfunctions are presenting with adverse cardiovascular manifestations which includes heart failure. Aim: The present study aimed to determine the existence of low T3 syndrome in patients with chronic heart failure. Material and Methods: This prospective study was conducted in the Department of General Medicine and Cardiology, KMC, and MGM Hospital, Warangal. patients with heart failure were included in the study. A total of n=100 patients were included in the study detailed physical examination was conducted to assess the patient's volume status (rales, edema, jugular venous distension), weight, height, body mass index, and orthostatic blood pressure changes. Complete blood count, blood glucose (fasting and 2 hours postprandial), Fasting serum lipid profile, blood urea, serum creatinine, and serum electrolytes were measured in all patients. Two-dimensional echocardiography was done in patients. Results:Analysis of Echocardiography parametersCompared to patients who were alive (n=90),left ventricular end-diastolic diameter was higher in those whodied (n=10). The mean ejection fraction in died and alive groups were27.19% and 35.12% respectively. Persons who died had asignificantly lower ejection fraction than those alive.When the mean ejection fraction was compared betweenpatients with low total T3 (T3<80 ng/dl) and normal T3 , patients with low T3 had a mean ejection fraction of 29.2% and those with normal T3 levels had a mean ejection fraction of 34.78%. This indicates the mean ejection fraction is lower in patients with low total T3 levels. Conclusion:Within the limitations of the present study it can be concluded that the prevalence of low T3 syndrome in patients with chronic heart failure is common. It was found that patients with lower T3 levels were having a lower ejection fraction.The LVEDD diameterwas negatively correlated with total T3. Therefore, Total T3 levels can be used as an adjunct to other parameters for risk stratification and survival estimation in chronic heart failure.

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Clinical and Prognostic Value of Duke's Activity Status Index Along With Plasma B-Type Natriuretic Peptide Levels in Chronic Heart Failure Secondary to Ischemic or Idiopathic Dilated Cardiomyopathy

The American Journal of Cardiology ◽

10.1016/j.amjcard.2008.08.045 ◽

2009 ◽

Vol 103 (1) ◽

pp. 73-75 ◽

Cited By ~ 27

Author(s):

John T. Parissis ◽

Maria Nikolaou ◽

Dionysia Birmpa ◽

Dimitrios Farmakis ◽

Ioannis Paraskevaidis ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Dilated Cardiomyopathy ◽

Natriuretic Peptide ◽

Prognostic Value ◽

Idiopathic Dilated Cardiomyopathy ◽

Status Index

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Visit-to-Visit B-Type Natriuretic Peptide Variability during the Previous Year Has Independent Prognostic Value in Patients with Stable Chronic Heart Failure

Cardiology ◽

10.1159/000500823 ◽

2019 ◽

Vol 143 (3-4) ◽

pp. 92-99 ◽

Cited By ~ 1

Author(s):

Nobuyuki Kagiyama ◽

Takuya Yuri ◽

Akihiro Hayashida ◽

Atsushi Hirohata ◽

Keizo Yamamoto ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Natriuretic Peptide ◽

Risk Score ◽

Prognostic Value ◽

Prognostic Significance ◽

Multivariable Analysis ◽

Hazard Ratio ◽

Stable Phase ◽

Wide Variability

Background: There is wide variability of visit-to-visit (V2V) B-type natriuretic peptide (BNP) in patients with chronic heart failure (CHF), even when they are stable. The prognostic significance of V2V-BNP variability has not been investigated. We aimed to test whether V2V-BNP variability during the stable period of CHF has prognostic value regardless of BNP level. Methods: In 278 stable outpatients (75 ± 10 years, 65% male) with CHF, we studied V2V-BNP variability, which was defined as the coefficient of variance of BNP values measured during 1 year before enrollment. All-cause death and rehospitalization due to HF were considered the primary endpoint. Results: The median V2V-BNP variability was 25.7% (IQR: 19.2–34.4%). During the follow-up period (median 3.2 years), 100 patients reached the endpoint and those with high V2V-BNP variability (≥25.7%) had a significantly higher rate of events (p = 0.001). CHF severity in terms of BNP level and MAGGIC risk score was not significantly different between those with high and low V2V-BNP variability. Multivariable analysis showed that high V2V-BNP variability was independently associated with increased event rates even after adjustment for other known prognostic predictors, including BNP (hazard ratio 1.90, p = 0.003), or for MAGGIC risk score and BNP (hazard ratio 1.72, p = 0.010). The hazard for the outcome consistently increased as V2V-BNP variability increased, with a marked increase up to about 30%. Conclusions: Even in the stable phase of CHF, V2V-BNP variability was associated with worse long-term outcomes, independent of BNP level.

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