The prognostic impact of thyroid function in pulmonary hypertension

Area of Science:

• Endocrinology
• Cardiology
• Pulmonology

Background:

• Thyroid disease is prevalent in pulmonary hypertension (PH) patients.
• The impact of thyroid function on long-term PH survival is not well understood.

Purpose of the Study:

• To investigate the prognostic significance of thyroid hormone levels (free triiodothyronine, free thyroxine, TSH) and thyroid hormone replacement (THR) therapy in PH patients.
• To identify thyroid function parameters associated with mortality in various PH subtypes.

Main Methods:

• Retrospective analysis of 1,756 patients from the Giessen PH Registry (1999-2013).
• Included patients with pulmonary arterial hypertension (PAH), idiopathic PAH (iPAH), PH due to left heart disease, PH due to lung diseases, and chronic thromboembolic PH (CTEPH).
• Utilized Cox regression and Kaplan-Meier analyses to assess mortality predictors.

Main Results:

• Absence of THR therapy independently predicted death in iPAH.
• Low or high TSH levels were associated with increased mortality in iPAH.
• Reduced free triiodothyronine (fT3) levels independently predicted death in PAH and CTEPH.

Conclusions:

• Thyroid hormone levels and THR therapy are significant prognostic factors in iPAH, PAH, and CTEPH.
• Further prospective studies are needed to confirm these findings and evaluate THR therapy's efficacy in PH.