title: Relation between free triiodothyronine/free thyroxine ratio, echocardiographic parameters and mortality in dilated cardiomyopathy.
abstract: BACKGROUND
  Abnormalities in thyroid function are frequent in patients with heart failure and are associated with increased mortality. However, the relation between thyroid hormone levels and echocardiographic parameters has not been investigated sufficiently.
  
  
  OBJECTIVE
  The aims of this study were to investigate the correlations of thyroid hormone levels with echocardiographic parameters and to evaluate their associations with subsequent mortality in a group of patients with dilated cardiomyopathy (DCMP).
  
  
  METHODS
  Serum levels of thyroid hormones were measured in 111 consecutive patients with DCMP (35 female, 76 male, mean age: 62+/-12 years). All patients underwent echocardiographic examination and were followed-up for a period of 12+/-8 months.
  
  
  RESULTS
  Twenty-three patients (21%) had abnormalities in thyroid function tests. Free triiodothyronine (fT3)/free thyroxine (fT4) ratio was significantly correlated with most of echocardiographic parameters, such as chamber diameters and ejection fraction. Sixteen patients (14%) died during the follow-up period; their fT3/fT4 ratio was significantly lower than the patients who survived (1.31+/-0.37 vs. 2.01+/-0.72, p<0.001). A fT3/fT4 ratio of <or=1.7 was associated with an increased risk of mortality (p<0.001), independent of other prognostic markers. Sensitivity, specificity, positive and negative predictivity of fT3/fT4 ratio <or=1.7 for cardiac mortality were 100%, 71%, 36% and 100%, respectively.
  
  
  CONCLUSIONS
  Determination of FT3/FT4 ratio may be a valuable and simple predictor for identification of patients with DCMP who are at high risk of subsequent mortality.
authors.affiliation: Department of Cardiology, Kocaeli University, Yahyakaptan Mah. A4 Blok Daire:3, Kocaeli 41050, Turkey. gkozdag@superonline.com
authors.forename: Guliz
authors.initials: G
authors.lastname: Kozdag
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
authors.forename: Ahmet
authors.initials: A
authors.lastname: Vural
authors.forename: Aysen
authors.initials: A
authors.lastname: Agacdiken
authors.forename: Goksel
authors.initials: G
authors.lastname: Kahraman
authors.forename: Tayfun
authors.initials: T
authors.lastname: Sahin
authors.forename: Ertan
authors.initials: E
authors.lastname: Ural
authors.forename: Baki
authors.initials: B
authors.lastname: Komsuoglu
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000000981:diagnostic imaging* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D013318:Stroke Volume; D015996:Survival Rate; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000031:analogs & derivatives* / Q000097:blood*; D014463:Ultrasonography
chemical_list: D014284:Triiodothyronine; C040407:3,3',5-triiodothyronamine; D013974:Thyroxine