The Prevalence of low T3 syndrome in chronic heart failure:\nA Hospital-based study

Abstract

Background: Effect of thyroid hormone on cardiac functions\nis mediated by biologically active T3 which binds to nuclear\nTR. There is increasing evidence that patients with mild thyroid\ndysfunctions are presenting with adverse cardiovascular\nmanifestations which includes heart failure.\nAim: The present study aimed to determine the existence of\nlow T3 syndrome in patients with chronic heart failure.\nMaterial and Methods: This prospective study was conducted\nin the Department of General Medicine and Cardiology, KMC,\nand MGM Hospital, Warangal. patients with heart failure were\nincluded in the study. A total of n=100 patients were included\nin the study detailed physical examination was conducted to\nassess the patient s volume status (rales, edema, jugular venous\ndistension), weight, height, body mass index, and orthostatic\nblood pressure changes. Complete blood count, blood glucose\n(fasting and 2 hours postprandial), Fasting serum lipid profile,\nblood urea, serum creatinine, and serum electrolytes were\nmeasured in all patients. Two-dimensional echocardiography\nwas done in patients.\nResults:Analysis of Echocardiography parametersCompared to\npatients who were alive (n=90),left ventricular end-diastolic\ndiameter was higher in those whodied (n=10). The mean\nejection fraction in died and alive groups were27.19% and\n35.12% respectively. Persons who died had asignificantly lower\nejection fraction than those alive.When the mean ejection\nfraction was compared betweenpatients with low total\nT3\n(T3<80 ng/dl) and normal T3\n, patients with low T3\n had a mean\nejection fraction of 29.2% and those with normal T3\n levels had\na mean ejection fraction of 34.78%. This indicates the mean\nejection fraction is lower in patients with low total T3\n levels.\nConclusion:Within the limitations of the present study it can\nbe concluded that the prevalence of low T3\n syndrome in\npatients with chronic heart failure is common. It was found\nthat patients with lower T3\n levels were having a lower ejection\nfraction.The LVEDD diameterwas negatively correlated with\ntotal T3. Therefore, Total T3\n levels can be used as an adjunct to\nother parameters for risk stratification and survival estimation\nin chronic heart failure.