PMID- 8960429
OWN - NLM
STAT- MEDLINE
DCOM- 19970314
LR  - 20190512
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 17
IP  - 12
DP  - 1996 Dec
TI  - Sick euthyroid syndrome in patients with moderate-to-severe chronic heart 
      failure.
PG  - 1860-6
AB  - BACKGROUND: Changes in peripheral thyroid hormone concentration and metabolism 
      can occur in euthyroid patients suffering from severe non-thyroidal illnesses. 
      Recently, sick euthyroid syndrome has been reported in patients suffering from 
      advanced heart failure. AIM: This study was to evaluate prospectively the 
      presence and pathophysiological implications of sick euthyroid syndrome in 
      moderate-to-severe chronic heart failure patients. METHODS: The study population 
      were 199 chronic heart failure patients admitted over a 2-year period to our 
      heart failure unit for assessment of cardiac transplantation. They were closely 
      followed up with clinical and instrumental examinations (including clinical, 
      hormonal, nutritional and cardiac function evaluations). Sick euthyroid syndrome 
      was defined as a serum total triiodothyronine value of less than the lowest 
      normal limit (< 1.23 nmol.l-1) in the presence of a normal serum thyroid 
      stimulating hormone concentration. RESULTS: Sick euthyroid syndrome was found in 
      36/199 patients (18%). According to the New York Heart Association (NYHA) 
      classification of severity of heart failure, sick euthyroid syndrome patients 
      appear in higher NYHA classes (31% of classes III and IV, vs 7% of class I and 
      II). Such patients also weigh less and are more frequently malnourished. 
      Alterations in cardiac index, ventricular filling pressures, functional 
      impairment, and the liver function parameters, were more significant in sick 
      euthyroid syndrome than in non-sick euthyroid syndrome patients. Serum 
      norepinephrine and atrial natriuretic factor were significantly higher, and 
      insulin significantly lower in the sick euthyroid syndrome group. During 
      follow-up, deaths were significantly more frequent in sick euthyroid syndrome 
      patients (13/27, 48%) than in non-sick euthyroid syndrome (30/141, 21%; P < 
      0.005). In six sick euthyroid syndrome patients who underwent heart 
      transplantation, mean total triiodothyronine values increased from 0.9 +/- 0.1 
      before to 1.96 +/- 0.3 nmol.l(-1)post-transplantation (P < 0.05). CONCLUSIONS: In 
      a large and representative population of patients with moderate-to-severe heart 
      failure, sick euthyroid syndrome shows a prevalence of 18%. Its occurrence was 
      related to the degree of functional cardiac impairment, but was not an 
      independent negative prognostic factor. Preliminary results indicate that heart 
      transplantation is associated with reversibility of sick euthyroid syndrome.
FAU - Opasich, C
AU  - Opasich C
AD  - S. Maugeri Foundation, Institute of Care and Scientific Research, Italy.
FAU - Pacini, F
AU  - Pacini F
FAU - Ambrosino, N
AU  - Ambrosino N
FAU - Riccardi, P G
AU  - Riccardi PG
FAU - Febo, O
AU  - Febo O
FAU - Ferrari, R
AU  - Ferrari R
FAU - Cobelli, F
AU  - Cobelli F
FAU - Tavazzi, L
AU  - Tavazzi L
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 1996 Dec;17(12):1777-8. PMID: 8960412
MH  - Adult
MH  - Analysis of Variance
MH  - Chi-Square Distribution
MH  - Chronic Disease
MH  - Euthyroid Sick Syndromes/*complications/diagnosis/*epidemiology
MH  - Female
MH  - Heart Failure/*complications/diagnosis/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Prospective Studies
MH  - Risk Factors
EDAT- 1996/12/01 00:00
MHDA- 1996/12/01 00:01
CRDT- 1996/12/01 00:00
PHST- 1996/12/01 00:00 [pubmed]
PHST- 1996/12/01 00:01 [medline]
PHST- 1996/12/01 00:00 [entrez]
AID - 10.1093/oxfordjournals.eurheartj.a014804 [doi]
PST - ppublish
SO  - Eur Heart J. 1996 Dec;17(12):1860-6. doi: 
      10.1093/oxfordjournals.eurheartj.a014804.