Chronic liothyronine (T3) treatment in stable heart failure patients with low T3 syndrome: A randomised, double-blind, cross-over, placebo-controlled intervention study (The LIHFA study)

Background: Thyroid abnormalities are common in chronic heart failure. Severity of heart failure rises by several fold in patients with thyroid dysfunction. Objectives: The purpose of this prospective study is to determine the correlation between low T3 syndrome and chronic heart failure with 2D echocardiography features & predicting the severity of chronic heart failure. Methods: In this descriptive, prospective cross sectional study, all patients who presented to the department of medicine with chronic heart failure during this study period of 12 months from January 2010-December 2011 in K.R.Hospital, Mysore were included. Patients were grouped into Low T3 chronic heart failure, hypothyroid chronic heart failure and chronic heart failure. Results: Mean age of low T3 chronic heart failure patients was higher than other two groups [60.50±6.15(SD) years, Systolic dysfunction on 2D Echo was more in low T3 dilated cardiomyopathy (20%), Diastolic dysfunction on 2D Echo was more in low T3 dilated cardiomyopathy group (30%), Pericardial effusion was seen in more number of patients with low T3 dilated cardiomyopathy (10%). Global hypokinesia was seen in more number of patients with low T3 dilated cardiomyopathy (30%). Segmental hypokinesia was seen in more number of patients with low T3 dilated cardiomyopathy (3%). Mean ejection fraction was seen in more number of patients with low T3 dilated cardiomyopathy [36.78±5.08 (SD) %]. Mean ejection fraction was lower in low T3 dilated cardiomyopathy [34.8±3.293 (SD) %].The high pulmonary artery systolic pressure was seen in more number of patients in low T3 dilated cardiomyopathy (70%). Conclusion: There is significant percentage of chronic heart failure patients having low T3 alone as biochemical parameter. It is important to recognize patients with chronic heart failure as it is associated with increased severity of heart failure. Asian Journal of Medical Science, Volume-5(3) 2014: 35-39 http://dx.doi.org/10.3126/ajms.v5i3.9522

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The Prevalence of low T3 syndrome in chronic heart failure: A Hospital-based study

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0803.05 ◽

2021 ◽

Vol 8 (3) ◽

pp. 20-24

Author(s):

Nishanam Gururaj ◽

Nithin Voruganti

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Complete Blood Count ◽

General Medicine ◽

Left Ventricular ◽

Biologically Active ◽

Low T3 Syndrome ◽

Low T3 ◽

The Mean

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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