Clinical Characteristics Of Patients With Chronic Heart Failure Complicated With Subclinical Hypothyroidism

Objective:Thyroid dysfunction such as hypothyroidism and hyperthyroidism have obvious effects on heart,but whether subclinical thyroid dysfunction can affects the heart is still unclear,the study aimed to investigate the clinical characteristics of patients with chronic heart failure complicated with subclinical hypothyroidism.Methods: 344 patients hospitalized in the Affiliated Hospital,Logistics University of Chinese People’s Armed Police Forces from January 1st,2010 to October 1st,2016 for chronic heart failure were enrolled in.Here’s how to filter the patients.2333 heart failure patients who acceptedthyroid function tests were filtered out by Le Jiu Medical System.Of these patients there are 291 Chronic heart failure patients(12.47%)with subclinical hypothyroidism.At last 344 patients were selected by artificial filtering.Basing on thyroid function levels,the cases were divided into two groups,the experimental group and control group,subclinical hypothyroidism group(111 cases)as group one,normal thyroid function group(233 cases)as group two,the group two was further divided into group A of 75 cases(TSH:4.5~9.9 m IU/L)and group B of 37 cases(TSH≥10m IU/L)according to TSH levels of cases.TSH,FT3,FT4,triglycerides,total cholesterol,LDL-C,HDL-C,NT-pro BNP,echocardiography were all measured.Clinical features,laboratory examination and echocardiography were comparedbetween euthyroid group and subclinical hypothyroidism group.Results:Leukocyte、red cell、hemoglobin were lower in subclinical hypothyroidism patients compared with euthyroid participants(P<0.05,P<0.01,P<0.01)。RBC was negatively correlated with TSH(r=-0.296,P<0.01)。 Hemoglobin was negatively correlated with TSH(r=-0.278,P<0.01).Patients with TSH>4.5m IU/L had a lower RBC、HB and leukocyte compared with euthyroid participants(P<0.05).Through correlation analysis,RBC and TSH hadnegative correlation(r=-0.296,P<0.001);Hemoglobin and TSH have negative correlation(r=-0.278,P<0.001);RBC and FT3 had positive correlation(r=0.237,P<0.001);Hemoglobin and FT3 had positive correlation(r=0.279,P<0.001).Logistic regression analysis showed that subclinical hypothyroidism(OR=2.077,95%CI 1.159~3.719,P=0.014)was the independent risk factor of anemia.Baseline peak E velocity,was greater in subclinical hypothyroidism patients compared with euthyroid participants(χ~2=8.267,P<0.05).Peak E velocity increase with the increase of TSH,and they were positively correlated(r=0.149,P<0.01).Conclusion:Subclinical hypothyroidism and anemia in patients with chronic heart failure were correlation.Subclinical hypothyroidism may worsen diastolic function in patients with chronic heart failure.