亚临床甲状腺功能低下预测心力衰竭的结果:来自T.O.S.CA.的见解. 登记处的注册表可以看到
Mariarosaria De Luca1, Roberta D'Assante1, Massimo Iacoviello2
1Department of Translational Medical Sciences, Federico II University, Naples, Italy.
Internal and emergency medicine
|June 8, 2024
概括
亚临床甲状腺功能低下症 (SH) 与心力衰竭中心血管死亡风险增加有关,心力衰竭患者的排泄分数减少 (HFrEF). 在HFrEF中早期发现和管理SH可能会改善患者的预后.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 亚临床甲状腺功能低下症 (SH) 普遍存在,其特征是甲状腺刺激激素 (TSH) 和正常的自由T4 (fT4) 的升高.
- 之前的研究表明,心力衰竭的预后较差,心力衰竭患者的心力衰竭率降低 (HFrEF) 患者有SH,但通常包括异质人群严重的SH.
研究的目的:
- 调查SH是否与30个月的随访期内HFrEF患者的心血管死亡率独立相关.
主要方法:
- 这项研究分析了来自未来T.O.S.CA.的277名HFrEF患者. 登记册. 登记册. 这是一本书.
- 患者被分为SH (TSH>4.5mIU/L,正常FT4) 和euthyroid组.
- 评估了临床数据,心声回声和生存结果.
主要成果:
- 二十三名患者有SH (87%轻度),254名患者是轻甲状腺,在年龄,性别,HF病因或射出分数方面没有显著差异.
- 在SH患者中,TSH水平较高 (7.7±4.1比1.6±0.9mIU/L,p<0.001),但FT4水平相似.
- 在调整了已确立的HF预测因素后,SH独立预测了心血管死亡率 (HR: 2.96; 95% CI: 1.13-7.74; p = 0.03).
结论:
- 亚临床甲状腺功能低下症是HFrEF患者心血管死亡率的独立预测因素.
- 在HFrEF患者中,应考虑广泛使用和廉价的甲状腺功能测试.
- 在HFrEF中检测和潜在地治疗SH可能提供一种改善患者预后的策略.
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