A Prospective Study of Low T3 Syndrome in Chronic Heart Failure

BACKGROUND: Thyroid abnormalities are common in chronic heart failure. Severity of heart failure rises by several fold in patients with thyroid dysfunction. OBJECTIVES: The purpose of this cross sectional comparative study is to determine the correlation between low T3 syndrome and chronic heart failure & predicting the severity of chronic heart failure. METHODS: In this descriptive, cross sectional study, all patients who presented to the Department of medicine with chronic heart failure during this study period of 12 months from January 2010-December 2011 in K.R.Hospital, Mysore were included. Patients were grouped into Low T3 chronic heart failure (10); hypothyroid chronic heart failure (29) and chronic heart failure (11) were included. RESULTS: Mean age of low T3 chronic heart failure patients was higher [60.506.15(SD) years], Higher number of hypertensives were seen in low T3 chronic heart rate patients, Cardiomyopathy was most common etiology for chronic heart failure patients (42%) and was common in the age group of 55-60 years (38%) in present study, idiopathic etiology was common in the age group of 60-65 years (63%), hypertensive heart disease as etiology was common with age group of 45-50 years (42.8%), IHD etiology was common with age group of 55-60 years (36.3%). Idiopathic etiology was common etiology with low T3 chronic heart rate patients (60%) and all patients was seen in the age group of 55-65 years. Mean pulse rate was higher in low T3 chronic heart failure group [1046.9 (SD) beats/min]. Systolic blood pressure was high in low T3 chronic heart rate group [13120.8 (SD) mm of Hg]; diastolic blood pressure was higher in low T3 chronic heart rate groups [84.612.4 (SD) mm of Hg]. S3 heart sound was present in more number of patients with low T3 chronic heart rate (60%), Systolic dysfunction on 2D Echo was more in low T3 chronic heart failure group (20%), Diastolic dysfunction on 2D Echo was more in low T3 chronic heart failure group (30%), Global hypokinesia was seen in more number of patients with low T3 chronic heart failure (30%).Segmental hypokinesia was seen in more number of patients with low T3 chronic heart failure (3%). Mean ejection fraction was seen in more number of patients with low T3 chronic heart failure [36.785.08 (SD) %].Mean ejection fraction was lower in low T3 chronic heart failure [34.83.293 (SD) %].The high pulmonary artery systolic pressure was seen in more number of patients in low T3 chronic heart failure (70%). CONCLUSION: There is significant percentage of chronic heart failure patients having low T3 alone as biochemical parameter. It is important to recognize patients with chronic heart failure as it is associated with increased severity of heart failure.