[Study on relationship among thyroid hormone relativity and Syndrome Differentiation-types of TCM in patients with congestive heart failure].
OBJECTIVE
To study the relationship between the TCM Syndrome Differentiation-types of congestive heart failure (CHF) and thyroid hormones, including triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH), and atrial natriuretic peptide (ANP), as well as cardiac function parameters, including left ventricular ejection fraction (LVEF), mean velocity of circumferentid fiber shortening (mVcf) and A peak/E peak (A/E).


METHODS
One hundred patients with CHF were divided into 4 Syndrome Differentiation-type groups, their cardiac function parameters, ANP and thyroid hormones were determined and compared with those in the 23 subjects in the control group.


RESULTS
In CHF patients with edema and blood stasis Syndrome type, the level of plasma ANP was significantly higher than that in the control group (P < 0.05); level of T3 was significantly lower than that in the control group and in CHF patients of other three (Xin-qi deficiency, Yin-deficiency and blood stasis) Syndrome groups (P < 0.01, P < 0.01, P < 0.05 and P < 0.01); levels of LVEF and mVcf were significantly lower than those in the other three Syndrome groups (all P < 0.01). Level of T4 in other three Syndrome groups significantly increased than that in the edema and blood stasis Syndrome type. A/E value showed a higher level in patients of all TCM type than that in the control (P < 0.01). Correlation analysis showed that T3 was positively correlated with LVEF and T4 (r = 0.200, P < 0.05, and r = 0.293, P < 0.01), and negatively correlated with ANP (r = -0.263, P < 0.01); T4 was negatively correlated with A/E (r = -0.226, P < 0.05).


CONCLUSIONS
The lowering of T3 and T4 and increasing of ANP may be one of the important reasons for lowering of LVEF in CHF patients with edema and blood stasis Syndrome-type. The decrease of T4 may be one of the important reasons for elevation of A/E and aggravation of left ventricular diastolic dysfunction in CHF patients of all the 4 TCM Syndrome-types.
Zhou
Jie
J
Department of Cardiology, Gansu Provincial TCM Hospital, Lanzhou 730050. zj2335211@sina.com
Gao
Xiao-ling
XL
Zhang
Bao-zhou
BZ
Huang
Shijun
S
Wang
Landi
L
Sheng
Li
L
Shi
Dongjing
D
Yan
Xiaoxia
X
Yang
Ani
A
Huang
Tenghui
T
Pei
Yuqin
Y
Chen
Jinfan
J
Cheng
Xuan
X
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009200:Myocardial Contraction; D013318:Stroke Volume / Q000502:physiology; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left
D013963:Thyroid Hormones; D014284:Triiodothyronine; D009320:Atrial Natriuretic Factor; D013972:Thyrotropin; D013974:Thyroxine