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A. Basics
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07. Syncope and Bradycardia
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Thyroid Hormone levels are negatively associated with clinical severity in Heart Failure with Preserved Ejection Fraction
Session:
Painel 1 - Insuficiência Cardíaca 7
Speaker:
Ana Rita Leite
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Posters
FP Number:
---
Authors:
Ana Leite; Francisco Vasques-Nóvoa; Francisca Saraiva; João Sérgio Neves; Marta Borges-Canha; Guilherme Ferreira; Filipe Macedo; José Paulo Araújo; Adelino Leite-Moreira
Abstract
<p><strong>Introduction</strong>: Heart failure (HF) is a leading cause of morbidity and mortality. Thyroid hormones (TH) are essential in cardiovascular homeostasis and may have a role in the pathogenesis of HF. However, in HF with preserved ejection fraction (HFpEF), the role of thyroid function in the clinical and functional domains of this syndrome has been poorly studied. </p> <p><strong>Aim</strong>: To evaluate the association of TH levels with clinical, laboratorial and echocardiographic parameters acquired during a stable phase in patients with HFpEF.</p> <p><strong>Methods</strong>: We used a single centre and prospective cohort study including stable HFpEF patients from ambulatory care. Participants with history of thyroid disease were excluded. The associations between TH [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4)] and NYHA class, BNP levels and echocardiographic measurements of cardiac structure and function were performed using linear regression models unadjusted and adjusted for age and sex (model 1), and for age, sex and body mass index (BMI) (model 2).</p> <p><strong>Results</strong>: We included 71 participants with mean age of 73.1±8.4 years and 64.8% were male. 98.6% of the subjects had hypertension, 91.5% had dyslipidaemia and 53.5% had diabetes. The mean BMI was 29.4±5.1 kg/m<sup>2</sup>. The median(interquartile range) of TSH, FT4 and FT3 were 1.51(1.00-1.97) μIU/mL, 1.03(0.92-1.14) ng/dL and 2.67(2.40-2.87) pg/mL, respectively. A negative association was observed between FT3 levels and NYHA class in model 1 (b=-0.52 [-0.93, -0.11]; p=0.01) and a trend for a negative association after additional adjustment for BMI (b=-0.40 [-0.80, 0.01], p=0.054). FT3 was also negatively associated with BNP levels (b=-0.91 [-1.54, -0.27]; p<0.01 in model 2). In systolic function, FT3 was positively associated with ejection fraction (b<strong>=</strong>5.23 [1.81, 8.66]; p<0.01 in model 2]. In diastolic function, FT4 was positively associated with E velocity (b=35.08 [4.46, 65.71]; p=0.03 in model 2) and FT3 was positively associated with E’ (b=2.06 [0.54, 3.57]; p<0.01 in model 2). TSH was not significantly associated with any parameter of cardiac structure or function.</p> <p><strong>Conclusions</strong>: TH levels are consistently associated with several markers of HFpEF severity. Higher FT3 levels are associated with a less severe phenotype of HFpEF, characterized by lower NYHA class and BNP levels and a higher E’ velocity. Our results support a role for TH in the pathogenesis and clinical progression of HFpEF.</p>
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