| Objective:Objective: With the aging of the population,the incidence of heartfailure has been increasing,and has become a major public health problem in today’sworld.World Health Organization prediction:By2020,cardiovascular disease willbecome the world’d first cause of death and leading cause of disability.In recentyears,the study found that in cases of heart failure,approximately40%-50%of patientswith left ventricular systolic function was normal,that is,normal left ventricular ejectionfraction,mainly left ventricular diastolic dysfunction,and the domestic and internationalstudies have shown that heart failure patients often present abnormal thyroid hormonelevels change.Therefore,in this study,heart failure with normal left ventricular ejectionfraction or not grouped,designed by measuring serum thyroid hormone levels of patientswith heart failure to observe normal and abnormal left ventricular ejection fraction heartfailure in patients with thyroid hormone levels change,thus made to determine theseverity of the disease and prognosis,further guidance on the clinical treatment.Methods:In this study,retrospective analysis of102cases of heart failure patientshospitalized in the Department of Cardiology of our hospital from September2009toFebruary2012as the heart failure group,all enrolled patients are in line with theFramingham heart failure diagnostic criteria,and except organic thyroid disease,seriousliver and kidney disease,severe infection,autoimmune disease and a history of endocrinediseases such as diabetes,and were not taking drugs that affect thyroid function,selectthe same period in the hospital examination of50healthy subjects as controlgroup.Then these two groups have no significant difference in the general clinical dataon age,gender composition and so on.Radioimmunoassay for the determination ofserum thyroid hormone levels in all subjects,namely free-triiodothyronine(FT3),free-thyroxine(FT4) and thyroid-stimulating hormone(sTSH) levels,respectively according to the NYHA cardiac function classification and cardiac color Dopplerdetermination of left ventricular ejection fraction(LVEF) was normal or not,the heartfailure group was divided into different sub-group,28cases of cardiac function Ⅱ,50cases of cardiac functioin Ⅲ,Ⅳ heart function24cases of grade,in LVEF≥50%groupof40cases,LVEF <50%of62cases,respectively,each subgroup of heart failure andcontrol groups,as well as the heart failure group were statistically analyzed to observebetween the different groups of thyroid hormone level changes.Results:1.FT3levels of the heart failure group was significantly lower than the healthcontrol group,statistical analysis P<0.05,ie, the difference was statistically significant;levelsof FT4,sTSH compared with control group,no significant difference (P>0.05).2.With theaggravation of the severity of heart failure,that is heart function deterioration,FT3decreased,and the more severe degree of heart failure,of FT3reduce the level of the moreobvious,statistical analysis showed that P<0.05which means the differences werestatistically significant;while the FT4,sTSH in the heart failure of various sub-groups,therewas no significant difference (P>0.05).3.Normal LVEF and abnormalities of the heartfailure patients had FT3levels decreased significantly (P<0.05),and reduced LVEF thannormal LVEF heart failure in patients with serum FT3levels declined slightly,but thedifference was not statistically significant (P>0.05); between the two groups,the FT4,sTSHcomparison was not a statistical difference (P>0.05).Conclusion: Normal and abnormal left ventricular ejection fraction in patients withheart failure there are abnormal changes in thyroid hormone levels,the performance ofeuthyroid sick syndrome (ESS),namely FT3levels significantly decrease and FT4,sTSHdon’t change significantly;and reduced LVEF than normal in patients heart failure serumFT3levels declined slightly,but the difference was not statistically significant(P>0.05),indicating that the changes of serum thyroid hormone levels are not onlyassociated with left ventricular systolic function,but also associated with diastolicfunction,that is,the existence of the ESS in diastolic heart failure is the same as that insystolic heart failure. Cardiac function associated with serum thyroid hormone levels:thelower the level of FT3,and more severe in patients with heart failure. Therefore,the normaland abnormal left ventricular heart failure,serum thyroid hormone levels in clinicalreference value to judge the severity and prognosis of the patient’s condition. |
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