| Objective:With the deepening of the research on the progression of heart failure in the neuroendocrine mechanism,it has been found in recent years that the pathological process of chronic heart failure is related to the abnormal metabolism of thyroid hormones.However,it is still unclear whether chronic heart failure patients with subclinical hypothyroidism need active thyroid hormone drug intervention.Therefore,this study will investigate the clinical efficacy of low-dose levothyroxine sodium adjuvant therapy in patients with chronic heart failure and subclinical hypothyroidism,in addition to routine correction of heart failure drug therapy.Method:We selected 80 patients with chronic heart failure and subclinical hypothyroidism hospitalized in Kunming Yan’an Hospital from June 2016 to August 2017(primary disease is hypertension heart disease,coronary atherosclerotic heart disease,dilated cardiomyopathy,pulmonary heart disease and so on).The enrolled patients were divided into two groups:the treatment group was given levothyroxine sodium and conventional anti-heart failure treatment(36 cases),and the control group was only given conventional anti-heart failure therapy(44 cases).After 6 months of follow-up,the heart function,quality of life,occurrence of major adverse cardiovascular events,and readmissions were observed in the two groups.The role of levothyroxine in the treatment of chronic heart failure was explored.Results:The average age of 80 patients enrolled in the study was(69.50±9.78)years.The composition ratio of heart failure was:coronary atherosclerotic heart disease accounted for 35.00%,hypertensive heart disease accounted for 28.70%,dilated cardiomyopathy accounted for 21.30.%,pulmonary heart disease accounted for 7.50%,and valvular heart disease accounted for 7.50%.At the time of enrollment,there was no significant difference in LAD,LVEDd,LVEF,FS,LVEDV,CI between the control group and the treatment group(P>0.05).Follow-up at 6 months:(1)Before and after the two groups were compared:In the treatment group,CI and LVEF in the echocardiographic results had a tendency of increasing compared with that of the group(P<0.01.P<0.05)and LVEDV has a decreasing trend(P<0.05).Changes in FS,LAD,and LVDd were not significant(P<0.05).In the control group,CI,LVEF and FS had a decreasing trend,LVEDV had a rising trend,and LAD and LVEDd had no obvious changes(P>0.05).(2)Between the two groups:CI and LVEF were significantly higher in the treatment group than in the control group(P<0.01,P<0.05).In the control group,CI,LVEF,and FS had a decreasing trend,and LVEDV,LAD,and LVEDd had a tendency to increase.(P>0.05).(3))The score of the SF-36 Concise Health Questionnaire indicated that the scores of physical health,physical role function,general health,mental health,and total scores in the treatment group were significantly higher than those in the control group(fP<0.01).(4)The incidence of major adverse cardiovascular events and readmissions were higher in the control group than in the treatment group(P>0.05).Conclusion:Treatment of chronic heart failure with subclinical hypothyroidism with low-dose levothyroxine:1.can improve the patient’s heart index,left ventricular ejection fraction,improve heart function.2.can improve physical health,role function,mental health scores,improve the overall quality of life of patients. |
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