Lower Levels of Triiodothyronine Are Associated with Poor Hemodynamic Profile and All-Cause Mortality in Heart Failure

Abstract

Background: We aimed to assess the association of triiodothyronine (T3) hormone with invasive hemodynamic parameters and all-cause mortality in heart failure with reduced ejection fraction (HFrEF). Results: About 483 HFrEF patients were enrolled. Patients with the lowest T3 tertile had advanced New York Heart Association (NYHA) classes, had higher uric acid, brain natriuretic peptide. T3 level had a positive correlation with cardiac index (CI) and a negative correlation with pulmonary vascular resistance and pulmonary capillary wedge pressure. Adjusted with NYHA III–IV classes, uric acid, aspartate aminotransferase and CI, T3 level was found to be an independent predictor of all-cause mortality. In Kaplan–Meier analysis, the lowest T3 tertile had the lowest survival function. Conclusion: Free T3 is positively correlated with CI and negatively correlated with pulmonary vascular resistance and pulmonary capillary wedge pressure in patients with HFrEF. Lower levels of T3 seems to be a poor prognostic factor in this particular patient population.

Protective Effects of Thyroid Hormone Deprivation on Progression of Maladaptive Cardiac Hypertrophy and Heart Failure

“…It was previously shown that hypercorrection of a hypothyroid-like state, which occurs in heart failure, e.g., by decreased TH receptor expression or increased deiodinase type 3 activity in heart, may restore cardiac function (20,(48)(49)(50)(51). Similarly, systemic hypothyroidism may confer cardiovascular morbidity and mortality and hence is widely regarded as a TH substitution indication (52)(53)(54). However, recent studies challenge this "one-for-all" concept (55)(56)(57) and have advocated a more risk-based TH treatment strategy in case of hypothyroidism (58,59).…”

Nomogram Model Establishment for Short-Term Survival Prediction in Hypothyroidism Patients with Heart Failure Based on the MIMIC-IV Database

“…Numerous studies have shown that hypothyroidism is an independent factor in uencing all-cause mortality in heart failure, both acute and chronic 8,9 . Currently, many studies have explored the prognostic factors of heart failure, with thyroid dysfunction being one of them 10,11 . However, there is a lack of speci c studies exploring the prognostic factors for hypothyroidism patients with heart failure and whether there are any differences compared to those without hypothyroidism.…”