title: Low plasma triiodothyronine levels in heart failure are associated with a reduced anabolic state and membrane damage.
abstract: BACKGROUND
  Low plasma triiodothyronine (T(3)) levels are considered a prognostic predictor of death in heart failure (HF) patients.
  
  
  OBJECTIVE
  To study an association between plasma T(3) levels and several cardiac, neurohormonal, and metabolic markers of HF.
  
  
  METHODS
  A total of 133 ambulatory HF patients (114 males; mean age 63.2 years) with left ventricular ejection fraction <40% were enrolled. TSH, total tetraiodothyronine (T(4)) and T(3), N-terminal pro-brain natriuretic peptide (NT-proBNP), and other cardiac and metabolic parameters were measured. The lowest tertile of T(3) (group 1) was compared against the two upper ones (group 2).
  
  
  RESULTS
  In simple logistic regression, the lowest T(3) tertile was associated with more advanced HF disease status: older (age: odds ratio (OR)=1.05; confidence interval (CI) 95% 1.01-1.09, P=0.004), lower functional capacity (walking test: OR=0.996; CI 95% 0.993-0.999, P=0.008), higher NT-proBNP (OR=1.64; CI 95% 1.19-2.27, P=0.003) and adiponectin levels (OR=1.07; CI 95% 1.02-1.11, P=0.004), lower DHEAS log-transformed (OR=0.50; CI 95% 0.31-0.80, P=0.004), and the presence of lower phase angle values as measured by body bioelectrical impedance analysis (OR=3.18; CI 95% 1.50-6.71, P=0.04) and worse renal function (OR=0.96; CI 95% 0.94-0.98, P=0.003). T(3) levels in the lowest tertile were independently associated with low phase angle values (OR=2.95, CI 95% 1.16-7.50, P=0.02) and the log transformation of DHEAS (OR=0.56; CI 95% 0.32-0.97, P=0.04).
  
  
  CONCLUSIONS
  We have demonstrated an association between plasma T(3) levels in the lower range and other deranged hormonal and metabolic parameters in HF patients.
authors: Department of Endocrinology, Cesar Milstein Hospital, La Rioja, CABA 1221, Buenos Aires, Argentina. gbrenta@gmail.com
authors: Gabriela
authors: G
authors: Brenta
authors: Jorge
authors: J
authors: Thierer
authors: Marcela
authors: M
authors: Sutton
authors: Adriana
authors: A
authors: Acosta
authors: Nora
authors: N
authors: Vainstein
authors: Fernando
authors: F
authors: Brites
authors: Laura
authors: L
authors: Boero
authors: Leonardo
authors: L
authors: Gómez Rosso
authors: Stefan
authors: S
authors: Anker
mesh_terms: D000368:Aged; D015415:Biomarkers; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000473:pathology; D004452:Echocardiography; D017097:Electric Impedance; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D006439:Hemodynamics / Q000502:physiology; D006728:Hormones / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood; D016015:Logistic Models; D008297:Male; D008566:Membranes / Q000473:pathology; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D014284:Triiodothyronine / Q000097:blood / Q000172:deficiency*; D016277:Ventricular Function, Left / Q000502:physiology; D016138:Walking / Q000502:physiology
chemical_list: D015415:Biomarkers; D006728:Hormones; D018377:Neurotransmitter Agents; D014284:Triiodothyronine