[Thyroid hormones and thyroid-stimulating hormone in patients with chronic heart failure--relationship between primary hypothyroidism with iodine organification defect and chronic heart failure].
Serum concentrations of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) were measured in 127 patients with chronic heart failure (CHF) (left ventricular ejection fraction; 40% < or = and NYHA; III-IV), and 1,079 patients without CHF (non-CHF) (left ventricular ejection fraction; 40% < or = and NYHA; I-II). Serum-T3, T4 and free-T4 were significantly decreased in patients with CHF. The prevalence of slight increase of serum TSH (5 < or = TSH < 15 microU/ml) were 20.5% in CHF and 4.08% in non-CHF. There was a statistically significant difference in the prevalence of slight increase of TSH (p < 0.01). In the patients with slight increase of serum TSH, the 123I-thyroid scintigraphy and perchlorate test were performed 12 patients with CHF and 19 patients with non-CHF. The incidences of iodine organification defect were 33.3% in CHF and 5.26% in non-CHF. There was a statistically significant difference in the incidence of iodine organification defect (p < 0.05). The histologic examination of thyroid biopsy specimen obtained 12 patients with CHF and primary hypothyroidism, these revealed only non-specific mild atrophic changes. Follicular damage and lymphocyte-infiltration were not evident. These findings suggest that the primary hypothyroidism were frequently complicated in CHF and associated with iodine organification defect by reduction of thyroid-peroxidase activity or decrease of hydrogen peroxidase. We conclude that the primary hypothyroidism with iodine organification defect was probably developed as a result of CHF.
Matsumura
K
K
Department of Cardiology, Kyoto South Hospital.
Nakase
E
E
Kawai
I
I
Saito
T
T
Kikkawa
N
N
Haiyama
T
T
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology*; D007453:Iodide Peroxidase / Q000172:deficiency; D008297:Male; D008875:Middle Aged; D013963:Thyroid Hormones / Q000097:blood*
D013963:Thyroid Hormones; D007453:Iodide Peroxidase