The purpose of the work is to investigate the features of the course of heart failure (HF) in patients with non-toxic goiter (NG).
Materials and methods. 222 patients with HF (with myocardial infarction) were examined. During hospitalization, a standardized assessment of the condition was performed, parameters of intra-cardiac hemodynamics, clinical and biochemical blood tests, and levels of thyroid gland hormones were determined.
Results and discussion. According to the data of the automatic regression analysis for NG, the following variables have a definite linkage in patients with HF: the frequency of re-admission for 2 years (R2 = 0.381; p = 0.0001), the presence of syndrome low T3 (SLT) (R2 = 0.141; p = 0, 0001), the presence of subclinical hypothyroidism (R2 = 0,139; p = 0,0001), HDL cholesterol level (R2 = 0,09; p = 0,004), body weight (R2 = 0,052; p = 0,028), number of migrated MI (R2 = 0,042; p = 0,049). The lowest frequency of re-hospitalization for 2 years was registered in patients with HF without NG (15.8%), while among patients with HF in the background of NG, this figure was 50% (χ2 = 27.881; p <0,0001). In the group of patients with HF, which runs on the background of NG, the frequency of SLT was 32.1% versus 10.6% among patients without NG (χ2 = 11.073; p <0.001). The highest incidence of favorable HF (absence of re-hospitalization) is observed in the group of patients without NG and without SLT (49.0%). At the same time, when combined with both HF and NG and SLT, the likelihood of re-admission is 59.2% (9 out of 17 patients) (χ2 = 13.271; p = 0.005). In patients with NG, a tendency towards a higher incidence of subclinical hypothyroidism (15.1%) was observed, compared with that among patients without nontoxic goiter (5.8%) (χ2 = 3.759; p = 0.053). Groups of patients differed in serum levels of HDL cholesterol and triiodothyronine. Thus, in the group of patients with NG, the revenus T3F was lower, compared with the group of patients without NG (3.15 [1.93 - 3.3.64] pmol / l, against 3.40 [2.62-3.77] pml / l) was 7.35% (p = 0.048) and the higher concentration of LPHD (1.18 [1.06 - 1.18] mmol / l versus 1.06 [1.06 - 1.21] mmol / l) - 11.32% (p = 0.016).
Conclusions Patients with heart failure who run on a background of non-toxic goiter have a significantly higher rate of re-hospitalization for 2 years. The reason for the unfavorable course of heart failure in patients with non-toxic goiter is likely to be a higher frequency of syndrome of low T3. Patients with heart failure and non-toxic goiter do not differ from those without morphological pathology of the thyroid gland by age, gender distribution and parameters of intracardiac hemodynamics.
Key words: cardiac insufficiency, nontoxic goiter, syndrome of low T3, course of disease.