triiodothyronine--reverse and Heart-Failure

To fully investigate the thyroid hormonal function in patients with the most common arrhythmia - atrial fibrillation.. 120 patients (aged 55-85 yrs) with symptoms of congestive heart failure exacerbation and no other concomitant disorders (inclusion criteria: normal cardiac troponin T at admission and 12 hours after, normal renal, hepatic and respiratory function; exclusion criteria: inflammatory state, history of myocardial infarction). Depending on the presence of permanent atrial fibrillation (PAF), patients were divided into two groups: PAF (34 females, 26 males) and regular sinus heart rhythm (43 females, 17 males), the groups did not differ in terms of heart rate, blood pressure, presence of overt/subclinical thyroid dysfunction, and medical therapy used. In all subjects thyroid stimulating hormone, free thyroxine, free triiodothyronine, reverse triiodothyronine were measured; echocardiography was performed.. PAF group showed higher FT4 and rT3 (1.41 vs. 1.27 ng/dl, p=0.0007; 0.61 vs. 0.32 ng/ml, p<0.0001, respectively). With ROC curve analysis the biochemical thyroid related factor of the highest prognostic value for PAF occurrence (with the highest sensitivity and specificity: 77% and 72%, respectively) was rT3 with the cut-off of above 0.3 ng/ml. Also, a positive correlation between rT3 levels and left ventricular posterior wall diameter was observed (Spearman's correlation coefficient 0.33, p=0.0093).. PAF is another condition where an increase in rT3 is observed. rT3 concentration above 0.3 ng/ml may be a novel biochemical sign associated with the presence of PAF in patients with chronic heart failure.

Topics: Aged; Aged, 80 and over; Atrial Fibrillation; Case-Control Studies; Cohort Studies; Female; Heart Failure; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; ROC Curve; Thyroid Function Tests; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Heart failure (HF) is frequently associated with euthyroid "sick" syndrome (low T3 and elevated rT3). We investigated if altered thyroid hormone in HF could affect expression of the TH receptor (TRalpha1), and alpha and beta myosin heavy chains (alpha-MHC, beta-MHC). HF was provoked in rats by aortic stenosis. We showed that rT3 generated from liver and kidney deiodination significantly increased and T3 decreased in HF; there was significantly higher TRalpha1 expression, no alpha-MHC expression, but beta-MHC expression. Changes in TRalpha could be compensating for low T3 from HF.

Topics: Animals; Euthyroid Sick Syndromes; Gene Expression Regulation; Heart Failure; Heart Ventricles; Male; Myosin Heavy Chains; Rats; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Statistics, Nonparametric; Thyroid Hormone Receptors alpha; Transforming Growth Factor beta; Triiodothyronine; Triiodothyronine, Reverse

In order to explore the relationship between congestive heart failure (CHF) and serum thyroxine, we assayed serum thyroxine level in 52 patients with CHF and 28 normal persons by means of radioimmunoassay (RIA). The results showed that triiodothyronine reduced and reverse triiodothyronine elevated significantly in the patients compared with the normal (P < 0.05). The more severe heart failure developed, the more obvious changes of the hormones were observed. The results suggest that the alterations of serum thyroid level may be used as an index of the severity of heart failure.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Female; Heart Failure; Humans; Male; Middle Aged; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

The relationship between cardiac function and serum thyroid hormone levels was investigated in 41 patients with chronic heart failure (25 men and 16 women, mean age 63.7 +/- 11.1 years) and 15 normal subjects (5 men and 10 women, mean age 55.5 +/- 12.2 years). Patients with apparent thyroid disease were excluded from the study. All patients were evaluated according to the New York Heart Association (NYHA) classification using echocardiography, cardiothoracic ratios, mean daily heart rates calculated from ambulatory electrocardiograms (ECG), and ventricular tachyarrhythmias greater than triplets based on either Holter or ECG monitoring. The serum free triiodothyronine (FT3), free thyroxine (FT4), and reverse triiodothyronine (rT3) levels were measured. Decreased FT3 levels and FT3/FT4 ratios, and increased rT3 levels were associated with worse NYHA class. FT3/FT4 was positively and rT3 was negatively correlated with echocardiographical fractional shortening. FT3 and rT3 were negatively and positively correlated with mean daily heart rates, in contrast to known hypothyroid patients. Patients with ventricular tachycardia demonstrated significantly lower serum values of FT3 and FT3/FT4, and significantly higher values of rT3. Serum thyroid hormone levels can provide a quantitative index for evaluating the severity of chronic heart failure and predicting ventricular tachycardia.

Topics: Echocardiography; Female; Heart; Heart Failure; Heart Rate; Humans; Male; Middle Aged; Tachycardia, Ventricular; Thyroid Hormones; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adult; Aorta; Coronary Vessels; Female; Forearm; Heart Failure; Humans; Male; Middle Aged; Pulmonary Artery; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse; Venae Cavae