Abstract. Heart failure (HF), as the final stage of the cardiovascular continuum, is associated with high mortality in most countries of the world. It is known that concomitant diseases and dynamics of a number of hormones, biomarkers, including interleukins (IL), are associated with the course of HF. Some ILs have predictive value that exceeds the accuracy of traditional risk markers. Non-toxic goiter (NTG) is one of the most common thyroid pathologies in our country. ILs play a role in the development of thyroid pathology. We know about the correlation with cytokines and serum levels of thyroid hormones. A study by scientists from Poland showed that human thyrocytes can synthesize ILs that activate T and B lymphocytes. The authors demonstrated that in patients with NTG there is an increase in the concentration of proinflammatory IL. It is possible to assume that there are certain features of the influence of IL on the course of HF in patients with NTG.
Objective: to study the relationship of the clinical course of heart failure (HF) in patients with non-toxic goiter (NTG) with blood levels of interleukins (IL).
Object and research methods. 354 patients with heart failure on the background of post-infarction cardiosclerosis were included. In 205 (57.9 %) patients, NS was diagnosed. The levels of tumor necrosis factor-a (TNFa), IL-1b, IL-4, IL-6, TSH, T3f and T4f were determined. Echocardioscopy and ultrasound of the thyroid gland (TG) were performed. The course of HF for 2 years was studied.
Results. Compared with the data in the reference group, patients with heart failure have higher levels of TNFa (by 38.8 %, p <0.0001), IL-6 (by 116.4 %, p <0.0001) and low the concentration of IL 4 (by 27.3 %, p <0.0001), as well as a larger value of the ratio of IL-1b/IL-4 (by 37.9 %, p <0.0001). Patients with heart failure in combination with low triiodothyronine syndrome (LTS) and NTG have significantly lower levels of IL-1b (by 21.9 %, p = 0.03) and IL-4 (by 11.5 %, p = 0.04). Patients without NTG who died within two years of observation had a higher level of TNFα (by 29.2 %, p = 0.01), and patients with a combined endpoint (CEP) tended to increase the content of IL-1b (by 16.6 %, p = 0.05). In patients with heart failure and with NG who had re-hospitalization, the level of IL-4 was significantly lower (by 14.4 %, p = 0.04), compared with that in patients with a favorable course of heart failure. A similar pattern was found in patients who had CEP (by 14.4 %, p = 0.02).
Conclusions. Interleukin levels may be associated with HF in patients with NTG. Patients with the above pathologies in combination with TNF have significantly lower levels of IL-1b and IL-4. In patients with HF in combination with NTG with re-hospitalization or CEP, the level of IL-4 is significantly lower. Patients without NTG who died had a higher level of TNFa, and patients with CEP tended to increase the content of IL-1b.
Key words: heart failure, non-toxic goiter, low T3 syndrome, tumor necrosis factor, interleukins, the course of the disease.