Abstract
Chronic heart failure is one of the leading causes of death globally, affecting 1.5 to 2% of the total world population and 2.9 to 3.9% of the total Western European population. Chronic heart failure often progresses rapidly in coexistence with endocrine pathology, namely hypothyroidism, that results in a more rapid development and further progression of endothelial dysfunction and the development of a systemic inflammatory response. The aim of our research was to study the levels of endothelin-1, C-reactive protein, tumor necrosis factor α and their correlation with the levels of thyroid-stimulating hormone, thyroxine in patients with chronic heart failure and coexisting hypothyroidism. There were examined 38 patients with chronic heart failure and coexisting hypothyroidism and 42 patients with chronic heart failure without hypothyroidism. The serum levels of endothelin-1, C-reactive protein, tumor necrosis factor α were determined by the enzyme-linked immunosorbent assay, while the levels of thyroid-stimulating hormone and thyroxine were determined by the electrochemiluminescence immunoassay. In patients with chronic heart failure and coexisting hypothyroidism, the levels of endothelin-1, C-reactive protein, and tumor necrosis factor α were 2.9, 1.5 and 2.27 times higher than those in patients without hypothyroidism. In Group I, there was a moderate positive correlation between the serum levels of endothelin-1 and thyroid-stimulating hormone and a weak negative correlation between the levels of thyroxine and endothelin-1. In Group II, there was a weak correlation between the levels of endothelin-1 and thyroid-stimulating hormone and no correlation between the levels of thyroxine and endothelin-1. In Group I, there was a strong positive correlation between C-reactive protein and thyroid-stimulating hormone levels as well; in Group II, no similar correlation was found. In Group I, there was found a moderate negative correlation between tumor necrosis factor α and thyroxine levels. According to our results, there was a close correlation between the markers of endothelial dysfunction, immune inflammatory response, and single markers of hypothyroidism.
Highlights
Chronic heart failure (CHF) is currently one of the most common public health issues that ranks first in mortality worldwide (Francois J et al 2020)
CHF is often accompanied by endocrine disorders, namely hypothyroidism
Structural and functional cardiac changes are present in patients at all the stages of hypothyroidism; the degree of these changes correlates with the severity and duration of the disease (Drapkina et al 2016)
Summary
Chronic heart failure (CHF) is currently one of the most common public health issues that ranks first in mortality worldwide (Francois J et al 2020). Structural and functional cardiac changes are present in patients at all the stages of hypothyroidism; the degree of these changes correlates with the severity and duration of the disease (Drapkina et al 2016). Congestive heart failure, blood stasis, hypoxia and hypercapnia affect thyroid function. Subclinical thyroid dysfunction with the serum thyroid-stimulating hormone (TSH) level > 10 mU/L is associated with a higher risk of HF progression. Low levels of thyroid hormone triiodothyronine (T3) alongside with normal TSH and thyroxine (T4) levels, the so-called low T3 syndrome, are associated with a higher risk of death (Kannan et al 2018)
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