Clinical Course and Lipid Metabolism Indicators in Patients with Chronic Heart Failure of Ischemic Genesis and Coexisting Hypothyroidism
Cardiac diseases, especially chronic heart failure which, according to the World Health Organization, affects 1.5-2% of the global population, are the number one cause of mortality and morbidity worldwide, including Ukraine. Chronic heart failure is often accompanied by endocrine disorders, especially hypothyroidism, the diagnosis of which has increased over the past 10 years, and which facilitates the rapid progression of heart failure due to reduced metabolic processes and altered lipid metabolism.
The objective of the research was to study clinical manifestations, lipid metabolism indicators and their relationship in patients with chronic heart failure of ischemic genesis and coexisting primary hypothyroidism.
Materials and Methods. 73 patients with the average age of 55.92±2.66 years were examined. They were divided into 2 groups: Group I included 38 patients with chronic heart failure and coexisting hypothyroidism; Group II comprised 35 heart failure patients without hypothyroidism. The clinical course of chronic heart failure itself and chronic heart failure with coexisting hypothyroidism was studied, the patients’ quality of life was evaluated, the myocardial function was studied by means of the 6-minute walk test, the indicators of lipid profile were analyzed by determining the serum levels of total cholesterol, low-density lipoprotein cholesterol. To assess thyroid function, thyroid-stimulating hormone and thyroxine levels were determined by the electrochemiluminescence immunoassay.
Results and Discussion. The clinical course and quality of life of patients with chronic heart failure and coexisting hypothyroidism were worse as compared to patients without hypothyroidism. The serum levels of total cholesterol, low-density lipoprotein cholesterol differed between both groups of patients (p<0.05).
Conclusions. Blood lipid profile was more significantly impaired in the patients with chronic heart failure of ischemic genesis and coexisting primary hypothyroidism that could result in the rapid progression of chronic heart failure, a more severe clinical course, and more frequent complications. The quality of life was higher in patients with heart failure without hypothyroidism and their condition was significantly better.
Yancy CW, Jessup M, Bozkurt B et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):1810-1852. Available from: https://doi.org/10.1161/CIR.0b013e31829e8807
Roth GA, Forouzanfar MH, Moran AE et al. Demographic and epidemiologic drivers of global cardiovascular mortality. N Engl J Med. 2015;372(14):1333-1341. Available from: https://doi.org/10.1056/NEJMoa1406656
Semenchuk SA, Stotska TV. Evaluation of life quality in patients with postinfarction cardiosclehrosis on the background of metabolitic therapy. Medical Science. 2017;8(16):42-44. Available from: https://doi.org/10.15587/2519-4798.2017.109226
Voronkov LG, Parashchenyuk LP. Kachestvo zhizni pri khronicheskoy serdechnoy nedostatochnosti: aktualnyye aspekty. Chast 1. Sertseva nedostatnist. 2010;2:12-16.
Heo S, Lennie TA, Okoli C et al. Quality of Life in Patients With Heart Failure: Ask the Patients. Heart Lung. 2009;38(2):100-108. Available from: https://doi.org/10.1016/j.hrtlng.2008.04.002
Voronkov LH. Patsiient iz KHSN v Ukraiini: analiz vsiieii populiatsii patsiientiv, obstezhenykh u ramkakh pershoho natsionalnoho zrizovoho doslidzhennia UNIVERS. Sertseva nedostatnist. 2012;1:8-13.
Rodondi N, den Elzen WP, Bauer DC et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA. 2010;304(12):1365-1374. Available from: https://doi.org/10.1001/jama.2010.1361
Tagami T, Kimura H, Ohtani S et al. Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia. Endocr J. 2011;58(6):449-457. Available from: https://doi.org/10.1507/endocrj.K11E-012
Jellinger P, Smith D, Mehta A et al. American Association of Clinical Endocrinologists' guidelines for management of dyslipidemia and prevention of atherosclerosis. Endocr Pract. 2012;18 Suppl 1:1-78. Available from: https://doi.org/10.4158/EP.18.S1.1
Willard DL, Leung AM, Pearce EN. Thyroid function testing in patients with newly diagnosed hyperlipidemia. JAMA Intern Med. 2014;174(2):287-289. Available from: https://doi.org/10.1001/jamainternmed.2013.12188
Stamatouli A, Bedoya P, Yavuz S. Hypothyroidism: Cardiovascular Endpoints of Thyroid Hormone Replacement. Front Endocrinol (Lausanne). 2020;10:888. Available from: https://doi.org/10.3389/fendo.2019.00888
Copyright (c) 2022 Iryna Kupnovytska, Yuliia Mykula
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).