The purpose: to investigate the effect of high concentrations of reversible triiodothyronine on the course of heart failure (HF).
The materials and methods. 221 patients with HF were examined in the background of postinfarction cardiosclerosis. The serum levels of thyroid-stimulating hormone (TSH), free T3 (T3fr) and T4 (T4fr), reversible T3 (T3r) were determinated. The echocardioscopy was performed. The flow of HF was studied.
The results and discussions. The patients with HF were divided into 2 groups according to the following criterion: the first group included 175 (79.19%) patients with normal serum T3r (<350 pg / ml). The second group included 46 (20.81%) patients with a high level of this hormone ≥ 350 pg / ml. In patients with HF and with a high level of T3r II functional class (FC) by NYHA HF was 30% more often compared to frequency in patients with normal level of the hormone (c2 = 7,711; p = 0.021); non-toxic goiter (0 vs. 8.0%, at c2 = 3.953; p = 0.047). These patients have an increased level of granulocytes (5.3%, p = 0.043), decreased relative content of monocytes (7.14%, p = 0.003); increased content of TSH (35.0%, p = 0.001) was also found, with a concordant increase in T4fr (17.0%, p = 0.002) and T3fr (11.7%, p = 0.041). These patients also have a lower left ventricular ejection fraction (5.26%, p = 0.037), a thinner interventricular sept (2.5%, p = 0.007), increased left (2.22%, p = 0.007) and right (at 1.86%, p = 0.003) atrium size, compared to those values in patients with normal levels of reversible triiodothyronine. The serum T3r level has a positive relationship with the presence of atrial fibrillation (r = 0.176; p = 0.028), with a relative content of granulocytes (r = 0.363; p <0.001); negative with thickness of the interventricular sept in diastole (r = -0.169; p = 0.048), with relative monocyte contents in blood (r = -0.204; p = 0.018). The model of high T3r level for HF included: FC HF (a = 0.160, p = 0.008), free T3 level (a = 0.095, p = 0.009), age of the first MI development (a = 0.012, p = 0.026).
Conclusions. 20.8% of patients with HF during hospitalization have high levels of T3r. These patients have probable increase in granulocytes (by 5.3%), a decrease in the relative content of monocytes (by 7.1%), an increase in TSH content (by 35.0%) with concordant increasing of T4fr (on 17.0%) and T3fr (by 11.7%); a smaller ejection fraction of the left ventricle (5.26%), a decrease in the size of the left (2.22%) and right (1.86%) atriums. The serum T3r level has a positive relationship with the presence of atrial fibrillation (r = 0.176; p = 0.028) with a relative content of granulocytes (r = 0.363; p <0.001); negative with the thickness of the interventricular sept in diastole (r = -0.169; p = 0.048), with the relative content of monocytes in the blood (r = -0.204; p = 0.018). The following parameters were included to the model: FC HF (a = 0.160, p = 0.008), level of T3fr (a = 0.095, p = 0.009), age of the first myocardial infarction (a = 0.012, p = 0.026).
Key words: heart failure, reversible triiodothyronine, course of disease, triiodothyronine, thyroxine.