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Low T3 syndrome predicts more adverse events in patients with hypertrophic cardiomyopathy

Chao-Jie He1, Chun-Yan Zhu2, Hong-Yan Fan1

  • 1Department of Cardiology, The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.

Clinical Cardiology
|September 15, 2023
PubMed

Insights

Low thyroid hormone levels (low T3 syndrome) are common in hypertrophic cardiomyopathy (HCM) patients and predict a higher risk of sudden cardiac death and worsening heart failure.

Area of Science:

  • Cardiology
  • Endocrinology
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a prevalent genetic heart disorder associated with sudden death and heart failure.
  • Thyroid dysfunction increases cardiovascular risks, necessitating investigation into its role in HCM outcomes.

Purpose of the Study:

  • To determine if thyroid hormones predict adverse events in patients with HCM.
  • To investigate the association between low triiodothyronine (T3) syndrome and adverse cardiovascular events in HCM patients.

Main Methods:

  • A cohort of 782 HCM patients with baseline thyroid hormone data was analyzed.
  • Patients were classified into normal fT3 and low T3 syndrome groups (fT3 < 2.43 pmol/L, normal TSH).
  • Kaplan-Meier and Cox regression analyses assessed sudden cardiac death (SCD) and worsening heart failure (WHF) events.

Main Results:

  • Low T3 syndrome was associated with significantly higher cumulative incidence of SCD (log-rank p=.02) and WHF (log-rank p=.001) events.
  • Multivariate Cox regression identified low T3 syndrome as a strong predictor of SCD (aHR: 1.53) and WHF (aHR: 3.87).
  • The median follow-up was 52 months, with 75 SCD and 134 WHF events recorded.

Conclusions:

  • Low T3 syndrome is prevalent in HCM patients and independently linked to increased risks of SCD and WHF.
  • Routine assessment of serum free triiodothyronine (fT3) may aid in risk stratification for HCM patients.
Abstract

Keywords:
heart failurehypertrophic cardiomyopathylow T3 syndromesudden cardiac death

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