心力衰竭中的甲状腺功能障碍与保存的喷射分数:系统性审查和元分析
Maryam Heidarpour1, Mania Banar1, Amir Parsa Abhari2
1Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA atherosclerosis
|December 31, 2025
概括
甲状腺功能障碍在心力衰竭患者中常见,具有保存的射出分数 (HFpEF). 这一系统性审查发现,HFpEF患者中明显甲状腺功能障碍的患病率为15%,低T3综合征的患病率为22%.
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:
- 甲状腺功能障碍通常被认为与心力衰竭与保留射出分数 (HFpEF) 有关.
- 关于甲状腺激素和HFpEF的现有研究提出了有争议的发现.
- 这项研究系统地审查了文献,以确定甲状腺功能障碍在HFpEF患者中的患病率.
研究的目的:
- 在被诊断为HFpEF的患者中系统地审查和估计甲状腺功能障碍的患病率.
- 分析HFpEF中明显甲状腺功能障碍,低T3综合征和亚临床甲状腺功能障碍 (SCH) 的患病率.
- 评估甲状腺功能障碍与HFpEF严重程度和结果之间的关联.
主要方法:
- 在主要数据库 (PubMed,Scopus,Web of Science,Embase,ProQuest) 进行了全面的文献搜索,截至2024年11月.
- 包括观察性研究,重点关注HFpEF患者甲状腺功能障碍的患病率.
- 使用随机效应模型计算聚合流行率,通过Trim和Fill测试,漏斗图和Egger测试评估出版偏差.
主要成果:
- 这项分析包括了14项研究,涉及3931名HFpEF受试者.
- 显而易见的甲状腺功能障碍的综合患病率为15% (95% CI:7%-29%).
- 患病率为22% (95% CI: 20%-25%) 的低T3综合征和15% (95% CI: 1%-68%) 的亚临床甲状腺功能障碍 (SCH).
结论:
- 甲状腺功能障碍似乎是HFpEF患者常见的并发症.
- 尽管研究异质,但研究结果表明甲状腺功能障碍与更严重的HFpEF症状之间存在潜在联系.
- 甲状腺功能障碍可能与HFpEF患者的较差结果有关.
相关概念视频
01:27Heart Failure I: Introduction
657
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
657
01:17Pathophysiology of Heart Failure
2.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.7K
01:29Heart Failure II: Pathophysiology
663
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
663
01:22Heart Failure Drugs: β-Blockers
727
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
727
01:30Heart Failure V: Medical Management
196
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
196
01:22Heart Failure Drugs: Diuretics
763
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
763