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[Study of serum thyroid hormone levels changes in perioperation patients accepted coronary artery bypass grafts]
Xin Li1, Huai-Bin Wang, Zhi-Ming Yao
1Department of Nuclear Medicine, Beijing Hospital, China Ministry of Health, Beijing 100730, China.
Insights
Thyroid hormone levels fluctuate around coronary artery bypass graft (CABG) surgery. Immediate post-surgery, total thyroxine (TT4) and free thyroxine (FT4) increase, while triiodothyronine (T3) and free triiodothyronine (FT3) decrease significantly, potentially indicating poor outcomes.
Area of Science:
- Cardiology
- Endocrinology
- Surgical Science
Context:
- Coronary artery bypass graft (CABG) surgery is a major cardiovascular intervention.
- Thyroid hormones play a crucial role in metabolic regulation and cardiovascular function.
- Understanding perioperative thyroid hormone dynamics is essential for patient management.
Purpose:
- To investigate the dynamic changes in serum thyroid hormone levels during the perioperative period of CABG.
- To correlate these hormonal changes with surgical events and patient outcomes.
Summary:
- Serum thyroid hormone levels (TT3, TT4, FT3, FT4, TSH, rT3) were measured in 62 CABG patients and 30 controls.
- Immediately after heparin administration during surgery, TT4 and FT4 levels significantly increased.
- Postoperatively, TT3, FT3, TT4, FT4, and TSH levels decreased significantly, with T3 and FT3 showing substantial reductions (52.7% and 46.6% at 24h).
- Reverse T3 (rT3) levels increased significantly at 24 hours post-CABG.
- Thyroid hormone levels did not normalize by 7 days post-surgery.
Impact:
- The study highlights significant perioperative thyroid hormone alterations in CABG patients.
- Elevated TT4 and FT4 in the acute phase and decreased T3/FT3 post-CABG may serve as predictive markers.
- These findings can inform clinical monitoring and therapeutic strategies for CABG patients.
Objective:
To clarify the change of serum thyroid hormone levels during perioperation period of coronary artery bypass grafts (CABG).
Methods:
The levels of serum thyroid hormones (TT(3), TT(4), FT(3), FT(4), TSH, rT(3)) were measured by chemical-luminal and RIA in 62 patients at certain time in perioperation period, as well as 30 normal volunteers on a fasting basis. SPSS 10.0 was used for statistic analysis.
Results:
The levels of serum thyroid hormones had no significant difference between controls and patients before CABG. At 10 min and 60 min after giving heparin, serum TT(4), FT(4) levels in patients during operation elevated significantly than before (P < 0.01), however, at 2 h after operation, serum TT(3), TT(4), FT(3), FT(4), rT(3), TSH levels had no significant changes. Serum TT(3), TT(4), FT(3), FT(4), TSH levels at 24 h and 72 h after operation were significantly lower in patients than before CABG (P < 0.01). Especially at 24 h, serum TT(3), FT(3) levels decreased by 52.7% and 46.6% than before respectively, while serum rT(3) levels increased significantly (P < 0.01) and serum TT(3), rT(3) levels decreased significantly (P < 0.01). The serum TT(4), FT(3), FT(4), TSH levels didn't return to normal at 7 d after operation.
Conclusion:
Elevated serum TT(4), FT(4) levels are present in acute period in patients accepted CABG. Decreased serum T(3) and FT(3) levels after CABG may indicate a bad prediction.
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