The relationship of thyroid hormone status with myocardial function in stress cardiomyopathy.
OBJECTIVE
This study aimed to investigate thyroid hormone (TH) status and its relationship with myocardial function as well as clinical and biochemical parameters in stress cardiomyopathy (CMP).


METHODS
Forty-five patients with stress CMP (the patient group), 31 patients without stress CMP (the control II group), and 58 healthy subjects (the control I group) were included. Sick euthyroid syndrome (SES) was defined as low total triiodothyronine (T(3)) with normal TSH levels.


RESULTS
In the patient group at admission, prevalence of SES was 62.2%. Compared with the control I group, the patient group had a decrease in left ventricular ejection fraction (LVEF) and systolic blood pressure (BP) and an increase in troponin-I, CK-MB, and B-type natriuretic peptide (BNP) levels. Total T(3) levels were reduced, and anti-thyroid peroxidase antibody (anti-TPO Ab) positivity, C-reactive protein (CRP) and cortisol levels were elevated. Total T(3) levels were associated with acute physiology and chronic health evaluation II (APACHE II) score, LVEF, systolic BP, and cortisol levels in multivariate analysis. In the control II group, total T(3) levels were not associated with any variables. In the SES (n=28) and myocardial dysfunction (MDys, n=27) subgroups, increased APACHE II score and BNP levels as well as decreased LVEF and systolic BP were significant. Total T(3) levels were reduced, and CRP, cortisol and catecholamines levels were elevated. In the MDys subgroup, anti-TPO Ab positivity and titer were increased.


CONCLUSIONS
These results suggest that total T(3) levels may be associated with myocardial contractility, clinical severity, and cortisol levels. Thyroid autoimmunity may influence myocardial contractility in stress CMP.
Lee
Seong Jin
SJ
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Hallym University, ChunCheon 200-702, Republic of Korea. leesj@hallym.ac.kr
Kang
Jun Goo
JG
Ryu
Ohk Hyun
OH
Kim
Chul Sik
CS
Ihm
Sung-Hee
SH
Choi
Moon Gi
MG
Yoo
Hyung Joon
HJ
Hong
Kyung Soon
KS
D000368:Aged; D001794:Blood Pressure; D016022:Case-Control Studies; D005067:Euthyroid Sick Syndromes / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020127:Recovery of Function / Q000502:physiology; D040921:Stress Disorders, Traumatic / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D054549:Takotsubo Cardiomyopathy / Q000097:blood* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D016277:Ventricular Function, Left / Q000502:physiology
D013963:Thyroid Hormones; D013972:Thyrotropin