| Objective: To observe change of the level of serum thyroid hormone and change of echocardiogram parameters(CO,SV,EF,FS,EDV) in inpatients with chronic heart failure before and after routine treatment.To explore the connection of the serum thyroid hormone with heart founction and echocardiogram parameters. And to ascertain the correlation of thyroid hormone with heart founction ,CO and EF ,respectively.Methods:Thirty-five subjects who have been finally diagnosed as chronic heart failure(CHF) in association with non-thyroidal illnesses.The age of the subjects ranges from 19 years old to 78 years old(mean age 54.97±14.88 years old).According to the difference of sex , heart function and treatment factor ,respectively, the subjects were divided to different subgroups.The control group consists of 24 healthy adults (mean age 50.33±13.31 years old). All the subjects with CHF were administrated to the conventioval medicine used to treat heart failure until heart function improved.The levels of serum Tetra-iodothyronine (T4), free thyroxine (FT4),tri-iodothyronine (T3), free tri-iodothyronine (FT3), thyrotropin (TSH) and reverse tri-iodothyronine(rT3) from both the treated groups and the control group were determined by immunochemilu-minometric assay(ICMA) before routine treatment , meanwhile the echocardiogram parameters(CO,SV,EF,FS,EDV)were also determined. When heart function improved (after about 7 to 20 days), to recheck those parameters in CHF patients. The difference of the level of thyroid hormone were compared between the subjects groups and the control group , and the difference of the level of thyroid hormone between the different heart function groups before treatment were also compared . The difference of TH levels and echocardiogram parameters in CHF groups before and after treatment was also compared. To compared the difference of the level of TH levels with the identical sex subjects group before and after treatment , and the difference of TH levels between the different sex groups before and after treatment was compared . And the correlation of the level of TH with heart function, EF and CO will be analyszed, respectively.Results:①The levels of T3 , FT3 and T3/ rT3 of all patients were lower than those of the normal control before treatment, and rT3 were higher (P< 0.05 ) ; The more serious the heart function degree was, the lower the levels of T3 ,FT3 and T3/ rT3 was , the higher the rT3 level was .②The levels of T3 and T3/ rT3 increased, and rT3 decreased significantly after conventional treatment(P< 0.05 ); and that the value of CO,SV,EF and FS also increased (P< 0.05 ) ;.③The levels of T3, T3/ rT3 increased and rT3 decreased in male subjects after treatment(P< 0.01 ) ; the levels of T3, FT4 and T3/ rT3 increased (P<0.05 ) and FT4 level decreased (P<0.01 ) after treatment in the female subjects.④The difference of changes of TH levels between the different sex treated groups before and after treatment were significant (P<0.05) . The increased level of T3/ rT3 in male group was more significant than that of female group after treatment(P<0.05). The decreased level of rT3 in male group was more significant than that of female group after treatment(P<0.05).⑤In CHF patients , the levels of T3 and T3/ rT3 showed a negative correlation with the degree of CHF , while rT3 showed a positive correlation with the degree of CHF.⑥T3 showed a positive correlation with EF and CO respectively as well as T3/rT3 ; rT3 showed a negative correlation with EF and CO respectively , TSH showed a negative correlation with CO.Conclusion: There are a metabolic disorder of thyroid hormone in chronic heart failure,the serum T3 level decreased , rT3 level increased,the level of T4 and TSH within normal level.After conventional treatment, with the improvement of heart function the metabolic disorder of thyroid hormone can been recovered in CHF patients. The change of thyroid hormone in CHF before and after treatment may have no relationship with sex .The level of TH have a possive correlation with the degree of heart function before treatment. The thyroid hormone level has a prognostic value in CHF patients and can be used as an indicator in assessing the cardiac dysfunction.
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