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Prognostic role of sub-clinical hypothyroidism in chronic heart failure outpatients

M Iacoviello1, P Guida, E Guastamacchia

  • 1Cardiology Unit, Emergency and Organ Transplantation Department, University of Bari, Bari, Italy. massimo.iacoviello@cardio.uniba.it

Current Pharmaceutical Design
|November 15, 2008
PubMed

Insights

Thyroid stimulating hormone (TSH) levels slightly above normal are linked to worsening chronic heart failure (CHF). This suggests subclinical hypothyroidism may impact CHF progression, warranting further research into treatment strategies.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Thyroid hormone levels may influence mortality in cardiovascular disease patients.
  • Subclinical hypothyroidism is a potential risk factor in chronic heart failure (CHF).

Purpose of the Study:

  • To investigate the prognostic significance of thyroid dysfunction in patients with stable CHF.
  • To determine if thyroid hormone levels predict heart failure progression.

Main Methods:

  • 338 stable CHF outpatients were assessed, excluding hyperthyroidism.
  • Evaluated physical exams, ECG, echocardiography, and blood markers including fT3, fT4, and TSH.
  • Follow-up averaged 15 months to track heart failure progression.

Main Results:

  • Heart failure progression occurred in 79 patients.
  • Univariate analysis linked TSH, fT3, fT4, and fT3/fT4 ratios to progression.
  • Multivariate analysis confirmed TSH as a continuous variable and subclinical hypothyroidism (TSH > 5.5 mUI/l) were independently associated with adverse events.

Conclusions:

  • Elevated TSH levels, even within the upper normal range, independently predict increased risk of heart failure progression in CHF patients.
  • Subclinical hypothyroidism may be an important prognostic factor in chronic heart failure.
  • Further studies are needed to establish optimal treatment for subclinical hypothyroidism in CHF.
Abstract

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