Related Experiment Videos

Triiodothyronine levels for risk stratification of patients with chronic heart failure

Alessandro Pingitore1, Patrizia Landi, Maria Chiara Taddei

  • 1Institute of Clinical Physiology, C.N.R., Pisa, Italy. pingi@ifc.cnr.it

The American Journal of Medicine
|February 8, 2005
PubMed

Insights

Low triiodothyronine (T3) levels are a significant independent predictor of mortality in chronic heart failure patients. This finding offers valuable prognostic information beyond traditional clinical assessments.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Medicine

Background:

  • Chronic heart failure (CHF) is a complex condition with significant mortality.
  • Prognostic assessment in CHF typically relies on clinical and functional parameters.
  • The role of thyroid hormones, specifically triiodothyronine (T3), in CHF prognosis requires further elucidation.

Purpose of the Study:

  • To investigate the utility of triiodothyronine (T3) concentrations as an adjunct to existing parameters for estimating prognosis in patients with chronic heart failure.
  • To determine if T3 levels provide independent prognostic value in CHF.

Main Methods:

  • A cohort of 281 patients with dilated cardiomyopathy (postischemic or nonischemic) was studied.
  • Total and free T3 concentrations were measured alongside traditional clinical and functional cardiac parameters.
  • Multivariate logistic regression models were employed to predict all-cause and cardiac mortality.

Main Results:

  • Lower ejection fraction, total T3, and free T3 levels were observed in patients who died compared to survivors.
  • Ejection fraction and total T3 levels independently predicted all-cause mortality.
  • Ejection fraction and free T3 levels also independently predicted all-cause mortality in an alternative model.
  • Male sex, ejection fraction, and total T3 levels were independent predictors of cardiac mortality.

Conclusions:

  • Low triiodothyronine (T3) levels serve as an independent predictor of mortality in patients diagnosed with chronic heart failure.
  • T3 concentrations provide incremental prognostic information that complements conventional clinical and functional cardiac assessments.
  • These findings highlight the potential of T3 measurement in refining risk stratification for CHF patients.
Abstract

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...