ackground : To determine the prevalence and significance of abnormal thyroid hormone
metabolism in congestive heart failure, serum triiodothyronine (T3), thyroxine (T4), free
triiodothyronine (FT3), free thyroxine (FT4), reverse triiodothyronine (rT3), and rT3/FT3
levels were obtained by RIA (radiommunoassay).
Methods : Thyroid hormone levels were measured by RIA in 32 patients of severe
congestive heart failure and 39 patients of moderate heart failure and 35 normal healthy
control persons who visited in Dong-A University Hospital between June 1990 and Sep. 1992.
Heart failure patients were divided into two groups by ejection fraction (E.F.) of
echocardiography (severe group, E.F.<30% ; moderate group 30% E.F.<50%).
Results :
1) Serum T3 levels in serve and moderate heart failure group and normal control were
94.73±18.54 ng/dl, 108.35±21.75 ng/dl, 115.11±28.00 ng/dl, and serum T3 levels were
significantly decreased in severe heart failure group.
Low serum T3 levels were observed in 18 (57%) of 32 severe heart failure group and
observed in 7 (18%) of 39 cases moderate heart failure group.
There was no significant difference of serum T4 levels among the 3 groups, and low
serum T4 levels were bsereved in 6 (19%) of 32 severe heart failure group and observed in 2
(5%) of 39 moderate heart failure group.
2) Serum FT3 levels were 1.65±0.24 pg/ml in severe heart failure group, 1.93±0.84 pg/ml
in moderate heart failure group, 2.17±0.92 pg/ml in normal control group, and significantly
decreased in severe heart failure group.
Low serum FT3 levels were detected in 7 (32%) of severe heart failure group and 3
(8%) of moderate heart failure group.
3) Serum rT3 levels were 391.00±92.00 pg/ml in severe heart failure group, 343.00±73.00
pg/ml in moderate heart failure group, 314.50±81.00 pg/ml in normal control gorup, and
significantly increased in severe heart failure group.
Increased serum rT3 levels were detected in 10(31%) of severe heart failure group and
4(10%) of moderate heart failure group.
4) rT3/FT3 were 237±97 in severe heart failure group, 177±81 in moderate heart failure
group, 140±71 in normal control group, and signifivantly increased in severe heart failure
group.
5) There was no significant differences of serum TSH and FT4 levels among the
severe, moderate heart failure group and normal control group.
Conclusions : These results suggest that the function of thyroid hormone, especially T3
level, was significantly decreased in severe heart failure patients (E.F.<30%) than in normal
persons.
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