title: Early activation of an altered thyroid hormone profile in asymptomatic or mildly symptomatic idiopathic left ventricular dysfunction.
abstract: BACKGROUND
  Although an altered thyroid metabolism has been documented in patients with overt heart failure, no evaluation has been made of a heart-thyroid interaction in mildly symptomatic patients with idiopathic left ventricular dysfunction (ILVD). We wanted to assess the thyroid state in patients with ILVD.
  
  
  RESULTS
  Eighty-six patients (age 60 +/- 10 years) were enrolled into the study. Thyroxine (T4), triiodothyronine (T3), thyrotropin, brain and atrial natriuretic peptides (BNP, ANP), noradrenaline, aldosterone, renin activity, and interleukin-6 were measured. Patients were divided into three groups: Group N with LV ejection fraction (EF) > or = 50% (n = 28), Group I with LVEF > 35%-< 50% (n = 34), Group II with LVEF < or = 35% (n = 24). There was a significant correlation between T3 and LVEF (r = 0.25, P = .02) and a negative correlation between T3 and BNP (r = -0.37, P < .0001). At univariate analysis T3 was a predictor of LV dysfunction, whereas BNP was the most important predictor at multivariate analysis (P = .002). T3 was the only predictor of New York Heart Association class at multivariate analysis.
  
  
  CONCLUSIONS
  An altered thyroid profile characterized by a reduction in peripheral production of biologically active T3 is related to LV dysfunction and early symptoms of heart failure in patients with ILVD.
authors.affiliation: Institute of Clinical Physiology, CNR, Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
authors.forename: Giorgio
authors.initials: G
authors.lastname: Iervasi
authors.forename: Andrea
authors.initials: A
authors.lastname: Barison
authors.forename: Concetta
authors.initials: C
authors.lastname: Prontera
authors.forename: Lorenza
authors.initials: L
authors.lastname: Pratali
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
authors.forename: Daniela
authors.initials: D
authors.lastname: Giannessi
authors.forename: Danilo
authors.initials: D
authors.lastname: Neglia
mesh_terms: D000368:Aged; D002303:Cardiac Output, Low / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000209:etiology; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009490:Neurosecretory Systems / Q000503:physiopathology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013318:Stroke Volume; D013961:Thyroid Gland / Q000503:physiopathology; D013963:Thyroid Hormones / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications / Q000503:physiopathology*
chemical_list: D006728:Hormones; D015850:Interleukin-6; D013963:Thyroid Hormones; D014284:Triiodothyronine; D020097:Natriuretic Peptide, Brain