Objective: to determine prognostic criteria for the course of heart failure in patients with non-toxic goiter.
Material and methods. In the study 381 patients with heart failure on the background of post-infarction cardiosclerosis were included. Of these, 218 patients had non-toxic goiter. The levels of TSH, T3fr, T4fr, T3r, NT-proBNP were evaluated. An echocardioscopy, an ultrasound examination of the thyroid gland were conducted. We studied the course of heart failure for 2 years.
Results. In patients with heart failure that occurs on the background of non-toxic goiter, compared to patients without it, a percentage of women is higher (respectively, 42.7% versus 16.6%, at p = 0.001); they more often have IV NYHA FC (respectively - 13.3%, against 5.5%; p = 0.043), 33.4% higher level of NT-proBNP (p = 0.001) and lower serum content of T3fr (2.30 pmol / L vs 2.76 pmol / L , at p = 0.0001); higher end-diastolic dimension of the left ventricle by 3.8% (p = 0.006), end-diastolic volume by 8.9% (p = 0.006), end-systolic dimension by 5.4% (p = 0.002), end-systolic volume by 13.2% (p = 0.002), 6.5% less ejection fraction (p = 0.02); high frequency of the "low T3" syndrome (odd ratio (OR) = 7.94 (4.04 - 15.61), p = 0.0001) and subclinical hypothyroidism (OR = 5.21 (1.52 - 17.90), p = 0.004 ), a high risk of re-hospitalization (OR = 3.037 (1.85 - 4.99), p = 0.0001) and a composite endpoint (OR = 2.53 (1.60 - 3.995), p = 0.001). Patients with non-toxic goiter without the "low T3" syndrome do not have a significant difference in the course of heart failure. In the group of patients with heart failure that flows on the background of non-toxic goiter and “low T3“ syndrome, there are high risks of re-hospitalization (OR = 6.82 (1.38 - 33.72), p = 0.022) and achievement of the composite endpoint (OR = 4.76 (1.17 - 19.41), p = 0.047) during 2 years of observation.
Conclusions. In heart failure with non-toxic goiter, with the "low T3" syndrome, it is possible to predict an unfavorable decease course during 2 years of observation: a high risk of re-hospitalization and composite endpoint.
Keywords: heart failure, non-toxic goiter, "low T3" syndrome, risk, course, prognosis.