BACKGROUND: It has been suggested that low thyroid hormones levels may be associated with increased mortality in patients with cardiovascular disease. AIM: To evaluate the prognostic role of thyroid function deficiency in patients with chronic heart failure (CHF). METHODS: We evaluated 338 consecutive outpatients with stable CHF receiving conventional therapy, all of whom underwent a physical examination, electrocardiography and echocardiography. Blood samples were drawn to assess renal function, and Na+, hemoglobin, NT-proBNPs, fT3, fT4 and TSH levels. Patients with hyperthyroidism were excluded. RESULTS: During the follow-up (15+/-8 months), heart failure progression was observed in 79 patients (including 18 who died of heart failure after hospitalisation and six who underwent transplantation). Univariate regression analysis showed that TSH (p<0.0001), fT3 (p<0.0001), fT4 (p=0.016) and fT3/fT4 (p<0.0001) were associated with heart failure progression but multivariate analysis showed that only TSH considered as a continuous variable (p = 0.001) as well as subclinical hypothyroidism (TSH > 5.5 mUI/l; p=0.014) remained significantly associated with the events. CONCLUSIONS: In CHF patients TSH levels even slightly above normal range are independently associated with a greater likelihood of heart failure progression. This supports the need for prospective studies aimed at clarifying the most appropriate therapeutic approach to sub-clinical hypothyroidism in such patients.
BACKGROUND: It has been suggested that low thyroid hormones levels may be associated with increased mortality in patients with cardiovascular disease. AIM: To evaluate the prognostic role of thyroid function deficiency in patients with chronic heart failure (CHF). METHODS: We evaluated 338 consecutive outpatients with stable CHF receiving conventional therapy, all of whom underwent a physical examination, electrocardiography and echocardiography. Blood samples were drawn to assess renal function, and Na+, hemoglobin, NT-proBNPs, fT3, fT4 and TSH levels. Patients with hyperthyroidism were excluded. RESULTS: During the follow-up (15+/-8 months), heart failure progression was observed in 79 patients (including 18 who died of heart failure after hospitalisation and six who underwent transplantation). Univariate regression analysis showed that TSH (p<0.0001), fT3 (p<0.0001), fT4 (p=0.016) and fT3/fT4 (p<0.0001) were associated with heart failure progression but multivariate analysis showed that only TSH considered as a continuous variable (p = 0.001) as well as subclinical hypothyroidism (TSH > 5.5 mUI/l; p=0.014) remained significantly associated with the events. CONCLUSIONS: In CHFpatientsTSH levels even slightly above normal range are independently associated with a greater likelihood of heart failure progression. This supports the need for prospective studies aimed at clarifying the most appropriate therapeutic approach to sub-clinical hypothyroidism in such patients.
Authors: Baris Gencer; Tinh-Hai Collet; Vanessa Virgini; Douglas C Bauer; Jacobijn Gussekloo; Anne R Cappola; David Nanchen; Wendy P J den Elzen; Philippe Balmer; Robert N Luben; Massimo Iacoviello; Vincenzo Triggiani; Jacques Cornuz; Anne B Newman; Kay-Tee Khaw; J Wouter Jukema; Rudi G J Westendorp; Eric Vittinghoff; Drahomir Aujesky; Nicolas Rodondi Journal: Circulation Date: 2012-07-19 Impact factor: 29.690
Authors: Christiaan L Meuwese; Merel van Diepen; Anne R Cappola; Mark J Sarnak; Michael G Shlipak; Douglas C Bauer; Linda P Fried; Massimo Iacoviello; Bert Vaes; Jean Degryse; Kay-Tee Khaw; Robert N Luben; Bjørn O Åsvold; Trine Bjøro; Lars J Vatten; Anton J M de Craen; Stella Trompet; Giorgio Iervasi; Sabrina Molinaro; Graziano Ceresini; Luigi Ferrucci; Robin P F Dullaart; Stephan J L Bakker; J Wouter Jukema; Patricia M Kearney; David J Stott; Robin P Peeters; Oscar H Franco; Henry Völzke; John P Walsh; Alexandra Bremner; José A Sgarbi; Rui M B Maciel; Misa Imaizumi; Waka Ohishi; Friedo W Dekker; Nicolas Rodondi; Jacobijn Gussekloo; Wendy P J den Elzen Journal: Nephrol Dial Transplant Date: 2019-04-01 Impact factor: 5.992
Authors: Christine Baumgartner; Bruno R da Costa; Tinh-Hai Collet; Martin Feller; Carmen Floriani; Douglas C Bauer; Anne R Cappola; Susan R Heckbert; Graziano Ceresini; Jacobijn Gussekloo; Wendy P J den Elzen; Robin P Peeters; Robert Luben; Henry Völzke; Marcus Dörr; John P Walsh; Alexandra Bremner; Massimo Iacoviello; Peter Macfarlane; Jan Heeringa; David J Stott; Rudi G J Westendorp; Kay-Tee Khaw; Jared W Magnani; Drahomir Aujesky; Nicolas Rodondi Journal: Circulation Date: 2017-10-23 Impact factor: 29.690
Authors: Layal Chaker; Christine Baumgartner; Wendy P J den Elzen; M Arfan Ikram; Manuel R Blum; Tinh-Hai Collet; Stephan J L Bakker; Abbas Dehghan; Christiane Drechsler; Robert N Luben; Albert Hofman; Marileen L P Portegies; Marco Medici; Giorgio Iervasi; David J Stott; Ian Ford; Alexandra Bremner; Christoph Wanner; Luigi Ferrucci; Anne B Newman; Robin P Dullaart; José A Sgarbi; Graziano Ceresini; Rui M B Maciel; Rudi G Westendorp; J Wouter Jukema; Misa Imaizumi; Jayne A Franklyn; Douglas C Bauer; John P Walsh; Salman Razvi; Kay-Tee Khaw; Anne R Cappola; Henry Völzke; Oscar H Franco; Jacobijn Gussekloo; Nicolas Rodondi; Robin P Peeters Journal: J Clin Endocrinol Metab Date: 2015-04-09 Impact factor: 5.958