Changes And Significance Of Serum Thyroid Hormones In Pediatric Patients With Cardiac Disease And Complicated With Congestive Heart Failure

AIM: In order to explore the changing rule of serum thyroid hormones in pediatric patients with CHF and clinical significance of the changes , we measured the level of thyroid hormones in patients with heart disease and complicated with CHF , we also studied the relationship between the level of the thyroid hormones and the cardiac function.METHODS: (1)Serum thyroid hormones level of patients with CHF were measured with radioimmunoassy and were compared with that of N-CHF group as well as normal control group .To study the relationship between hormones level and cardiac function , we compared the thyroid hormones level of vary grades of cardiac function. (2)Criteria(SV, CO, CI,EF,FS)of cardiac function were measured by ultrasonic cardiography and were compared with the thyroid level so as to investigate the relationship between them . (3)To study the changing rule of thyroid hormones in patients with CHF the thyroid level were dynamically observed .RESULTS: (1)TT3,FT3 and FT4 were significantly lower in patients with CHF in comparison with N-CHF group and normal group (P<0.05), while rT3 was significantly higher (P<0.05) , while TT4 was slightly lower without significance(P>0.05) .Except TSH , there were no cignificant diffrence between N-CHF group and normal controlgroup . (2)Along with the aggravation of heart failure , serum level of TT3, FT3, TT4 and FT4 progressively decreased, while rT3 progressivly increased . Serum TSH is not related to the severity of CHF (P>0.05) . (3)The changes of TT3, FT3,TT4 FT4 were positively correlated to the cardiac function criteria (EF, CI, FS), while rT3 was negtively correlated. TSH was not correlated to the cardiac function . (4) After 3 weeks treatment serum thyroid hormones level recovered in most of patients (P<0.01) , while that of patients with stubborn heart failure did not recover persistantly .CONCLUSION: (1) Serum thyroid hormones changes exist in pediatric patients with CHF. (2)The extent of serum thyroid hormones changing are associated withthe cardiac function . (3) As the heart failure iscorrected ,the abnormal serum thyroid hormones levelrestores . A persistent abnormal serum thyroid hormones is often found in patients with stubborn heart failure and implicates a worse cardiac function and unfavorabletherapeutic effect.