Effects of triiodothyronine replacement therapy in patients with chronic stable heart failure and low‐triiodothyronine syndrome: a randomized, double‐blind, placebo‐controlled study

ESC Heart Failure

Ahmad Amin²  Mitra Chitsazan¹  Sepideh Taghavi² 

[1] ORCID:orcid.org/0000-0002-3755-8644;Rajaei Cardiovascular Medical and Research Center, Tehran, Iran

关键词: Congestive heart failure;    Liothyronine;    Low‐T3 syndrome;   

DOI  :  10.1002/ehf2.12025

来源: Wiley

【 摘 要 】

Abstract

Objectives

The present study assessed the changes in functional, biochemical, and echocardiographic measures following long-term liothyronine therapy in heart failure (HF) patients with low-triiodothyronine (T3) syndrome (LT3S).

Methods

In the present placebo-controlled, double-blind study, adult patients with clinically stable New York Heart Association functional class I–III systolic HF and LT3S receiving standard HF therapy were randomly assigned 1:1 to receive oral liothyronine or placebo for 6 weeks. Low-T3 syndrome was defined as a serum free T3 of less than the lower limit of normal (<2.4 pg/mL) with normal thyroid-stimulating hormone (thyrotropin) and free thyroxin values.

Results

Fifty patients, including 39 (78%) men with a mean ± standard deviation age of 60 ± 15 years were included. The 6-min walk distance increased in the liothyronine group by 93 ± 16 m and in the placebo group by 67 ± 28 m, resulting in a treatment effect of 26 m (P = 0.003). A higher decrease of high-sensitivity C-reactive protein level was seen in the liothyronine group than in the placebo group (P = 0.009). Liothyronine markedly decreased serum N-terminal pro-brain natriuretic peptide level compared with the placebo (P = 0.01). A significant increase was also seen in the left ventricular ejection fraction by liothyronine as compared with the placebo (<0.001).

Conclusion

Triiodothyronine replacement by chronic liothyronine therapy seems to safely benefit stable HF patients with LT3S receiving optimal HF medications.

【 授权许可】

CC BY-NC-ND   
© 2015 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.