Forecasting the course of a heart failure in patients with a non-toxic goiter, accounting function of the thyroid gland

Authors

  • Sergiy Pyvovar Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039, Ukraine https://orcid.org/0000-0003-3446-2767
  • Iurii Rudyk Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039, Ukraine https://orcid.org/0000-0002-3363-868X
  • Tetiana Lozyk Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039, Ukraine https://orcid.org/0000-0001-8188-1898
  • Valentyna Galchinska Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039, Ukraine https://orcid.org/0000-0002-0024-131X
  • Tetiana Chenchik Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039, Ukraine https://orcid.org/0000-0001-7170-5313

DOI:

https://doi.org/10.15587/2519-4798.2020.192359

Keywords:

heart failure, non-toxic goiter, "low T3" syndrome, risk, course, prognosis

Abstract

The aim: to determine prognostic criteria for the course of heart failure in patients with non-toxic goiter.

Material and methods. In the study 381 patients with heart failure on the background of post-infarction cardiosclerosis were included. Of these, 218 patients had non-toxic goiter. The levels of TSH, T3fr, T4fr, T3r, NT-proBNP were evaluated. An echocardioscopy, an ultrasound examination of the thyroid gland were conducted. We studied the course of heart failure for 2 years.

Results. In patients with heart failure that occurs on the background of non-toxic goiter, compared to patients without it, a percentage of women is higher (respectively, 42.7 % versus 16.6 %, at p=0.001); they more often have IV NYHA FC (respectively – 13.3 %, against 5.5 %; p=0.043), 33.4 % higher level of NT-proBNP (p=0.001) and lower serum content of T3fr (2.30 pmol/L vs 2.76 pmol/L , at p=0.0001); higher end-diastolic dimension of the left ventricle by 3.8 % (p=0.006), end-diastolic volume by 8.9 % (p=0.006), end-systolic dimension by 5.4 % (p=0.002), end-systolic volume by 13.2 % (p=0.002), 6.5 % less ejection fraction (p=0.02); high frequency of the "low T3" syndrome (odd ratio (OR)=7.94 (4.04–15.61), p=0.0001) and subclinical hypothyroidism (OR=5.21 (1.52–17.90), p=0.004), a high risk of re-hospitalization (OR=3.037 (1.85–4.99), p=0.0001) and a composite endpoint (OR=2.53 (1.60–3.995), p=0.001). Patients with non-toxic goiter without the "low T3" syndrome did not have a significant difference in the course of heart failure. In the group of patients with heart failure that flew on the background of non-toxic goiter and “low T3“ syndrome, there were high risks of re-hospitalization (OR=6.82 (1.38–33.72), p=0.022) and achievement of the composite endpoint (OR=4.76 (1.17–19.41), p=0.047) during 2 years of observation.

Conclusions. In heart failure with non-toxic goiter, with the "low T3" syndrome, it is possible to predict an unfavorable decease course during 2 years of observation: a high risk of re-hospitalization and composite endpoint

Author Biographies

Sergiy Pyvovar, Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039

PhD, Senior Researcher

Department of Clinical Pharmacology and Pharmacogenetics non Infective Diseases

Iurii Rudyk, Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039

MD, Senior Researcher, Head of Department

Department of Clinical Pharmacology and Pharmacogenetics non Infective Diseases

Tetiana Lozyk, Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039

Researcher

Department of Clinical Pharmacology and Pharmacogenetics non Infective Diseases

Valentyna Galchinska, Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039

PhD, Senior Researcher, Head of Laboratory

Laboratory of Immuno-Biochemical and Molecular-Genetics Researches

Tetiana Chenchik, Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” Maloi L. ave., 2 a, Kharkiv, Ukraine, 61039

PhD, Senior researcher

Laboratory of Immuno-Biochemical and Molecular-Genetics Researches

References

  1. Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S. et. al. (2016). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2016. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC European Heart Journal, 37 (27), 2129–2200. doi: http://doi.org/10.1093/eurheartj/ehw128
  2. Kolomoyets, M. Yu., Vashenyak, O. O. (2012). Comorbidity and polymorbidity in therapeutic practice. Ukrayinskyy medychnyy zhurnal, 5 (91), IX–X.
  3. Yuzvenko, T. Y. (2016). Features of Type 2 Diabetes Mellitus in Combination with Hypothyroidism. International Journal of Endocrinology, 8 (72), 73–77. doi: http://doi.org/10.22141/2224-0721.8.72.2015.72341
  4. Vatseba, T. S., Skrypnyk, N. V. (2013). Correction of insulin resistance in patients with primary hypothyroidism in conditions of iodine deficiency. International Journal of Endocrinology, 6 (54), 92–93.
  5. Zimmermann, M. B., Boelaert, K. (2015). Iodine deficiency and thyroid disorders. The Lancet Diabetes & Endocrinology, 3 (4), 286–295. doi: http://doi.org/10.1016/s2213-8587(14)70225-6
  6. Moghaddam, P. A., Virk, R., Sakhdari, A., Prasad, M. L., Cosar, E. F., Khan, A. (2016). Five Top Stories in Thyroid Pathology. Archives of Pathology & Laboratory Medicine, 140 (2), 158–170. doi: http://doi.org/10.5858/arpa.2014-0468-ra
  7. Vanderpump, M. P. J. (2011). The epidemiology of thyroid disease. British Medical Bulletin, 99 (1), 39–51. doi: http://doi.org/10.1093/bmb/ldr030
  8. Biondi, B., Cooper, D. S. (2007). The Clinical Significance of Subclinical Thyroid Dysfunction. Endocrine Reviews, 29 (1), 76–131. doi: http://doi.org/10.1210/er.2006-0043
  9. Pyvovar, S. M., Rudyk, Y. S., Lozyk, T. V., Halchinska, V. Y., Chenchyk, T. O. (2019). The features of “low T3” syndrome definition in a heart failure and its effect on a course of the disease. Zaporozhye Medical Journal, 21 (4 (115)), 437–443. doi: http://doi.org/10.14739/2310-1210.2019.4.173178
  10. Greenland, S., Pearl, J., Robins, J. M. (1999). Causal Diagrams for Epidemiologic Research. Epidemiology, 10 (1), 37–48. doi: http://doi.org/10.1097/00001648-199901000-00008
  11. Bonnema, S. J., Hegedüs, L. (2009). A 30-year perspective on radioiodine therapy of benign nontoxic multinodular goiter*. Current Opinion in Endocrinology, Diabetes and Obesity, 16 (5), 379–384. doi: http://doi.org/10.1097/med.0b013e32832ff2e1
  12. Tunbridge, W. M. G., Evered, D. C., Hall, R., Appleton, D., Brewis, M., Clark, F. et. al. (1977). The spectrum of thyroid disease in a community: the whickham survey. Clinical Endocrinology, 7 (6), 481–493. doi: http://doi.org/10.1111/j.1365-2265.1977.tb01340.x
  13. Tan, G. H. (1997). Thyroid Incidentalomas: Management Approaches to Nonpalpable Nodules Discovered Incidentally on Thyroid Imaging. Annals of Internal Medicine, 126 (3), 226–231. doi: http://doi.org/10.7326/0003-4819-126-3-199702010-00009
  14. Turchina, S. I., Nachetova, T. A. (2017). Dystyreoz as risk factors for the formation of secondary amenoreyeyi girls who live in low iodine deficiency. Health of woman, 8 (124), 16–20.
  15. Krohn, K., Führer, D., Bayer, Y., Eszlinger, M., Brauer, V., Neumann, S., Paschke, R. (2004). Molecular Pathogenesis of Euthyroid and Toxic Multinodular Goiter. Endocrine Reviews, 26 (4), 504–524. doi: http://doi.org/10.1210/er.2004-0005
  16. Moreno, J. C., Visser, T. J. (2010). Genetics and phenomics of hypothyroidism and goiter due to iodotyrosine deiodinase (DEHAL1) gene mutations. Molecular and Cellular Endocrinology, 322 (1-2), 91–98. doi: http://doi.org/10.1016/j.mce.2010.03.010
  17. Larsen, P. R., Zavacki, A. M. (2012). Role of the Iodothyronine Deiodinases in the Physiology and Pathophysiology of Thyroid Hormone Action. European Thyroid Journal, 1, 232–242. doi: http://doi.org/10.1159/000343922
  18. De Groot, L. J. (2006). Non-Thyroidal Illness Syndrome is a Manifestation of Hypothalamic-Pituitary Dysfunction, and in View of Current Evidence, Should be Treated with Appropriate Replacement Therapies. Critical Care Clinics, 22 (1), 57–86. doi: http://doi.org/10.1016/j.ccc.2005.10.001
  19. Osadtsiv, O. I. (2014). Selenium efficiency in prophylaxis and complex treatment of diffuse goiter. Likarska sprava, 7-8, 110–116.
  20. Hayashi, T., Hasegawa, T., Kanzaki, H., Funada, A., Amaki, M., Takahama, H. et. al. (2016). Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure. ESC Heart Failure, 3 (3), 168–176. doi: http://doi.org/10.1002/ehf2.12084
  21. Danzi, S., Klein, I. (2014). Thyroid Disease and the Cardiovascular System. Endocrinology and Metabolism Clinics of North America, 43 (2), 517–528. doi: http://doi.org/10.1016/j.ecl.2014.02.005
  22. Pacella, C. M., Mauri, G., Achille, G., Barbaro, D., Bizzarri, G., De Feo, P. et. al. (2015). Outcomes and Risk Factors for Complications of Laser Ablation for Thyroid Nodules: A Multicenter Study on 1531 Patients. The Journal of Clinical Endocrinology & Metabolism, 100 (10), 3903–3910. doi: http://doi.org/10.1210/jc.2015-1964

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Published

2019-01-30

How to Cite

Pyvovar, S., Rudyk, I., Lozyk, T., Galchinska, V., & Chenchik, T. (2019). Forecasting the course of a heart failure in patients with a non-toxic goiter, accounting function of the thyroid gland. ScienceRise: Medical Science, (1 (34), 4–9. https://doi.org/10.15587/2519-4798.2020.192359

Issue

No. 1 (34) (2020)

Section

Medical Science

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Copyright (c) 2020 Sergiy Pyvovar, Iurii Rudyk, Tetiana Lozyk, Valentyna Galchinska, Tetiana Chenchik

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