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Triiodothyronine levels for risk stratification of patients with chronic heart failure
Open accessAbstract
Purpose We sought to explore the use of triiodothyronine (T(3)) concentrations as an adjunct to clinical and functional parameters when estimating prognosis in patients with chronic heart failure.Methods We enrolled 281 patients with postischemic (n = 153) or nonischemic (n = 128) dilated cardiomyopathy. Total and free T(3) concentrations, and traditional clinical and functional cardiac parameters, were measured 2 to 5 days after hospital admission. A multivariate model was utilized to predict all-cause and cardiac mortality.Results All-cause mortality was 23% (n = 64) after a mean (+/-SD) of 12 +/- 7 months of follow-up; 47 (73%) of the patients died from cardiac causes. The mean ejection fraction was lower in those patients who died than in those who survived (26% +/- 8% vs. 31% +/- 8%, P < 0.001), as were levels of total T(3) (1.0 +/- 0.4 nmol/L vs. 1.3 +/- 0.3 nmol/L, P < 0.001) and free T(3) (3.2 +/- 1.4 pmol/L vs. 3.7 +/- 1.0 pmol/L, P < 0.001). In a multivariate model, ejection fraction (odds ratio [OR] = 2.0 per 10% decrease; 95% confidence interval [CI]: 1.4 to 2.8 per 10% decrease; P < 0.001) and total T(3) level (OR = 0.3 per 1-nmol/L increase; 95% CI: 0.1 to 0.5 per 1-nmol/L increase; P < 0.001) were the only independent predictors of all-cause mortality. In an alternative model using free T(3) levels, ejection fraction (OR = 1.9; 95% CI: 1.4 to 2.7; P < 0.001) and free T(3) level (OR = 0.6 per 1 pmol/L; 95% CI: 0.5 to 0.8 per 1 pmol/L; P <0.02) were associated with all-cause mortality. When we considered cardiac mortality alone, male sex (OR = 3.5; 95% CI: 1.7 to 13; P < 0.04), ejection fraction (OR = 1.7; 95% CI: 1.2 to 2.5; P < 0.006), and total T(3) level (OR = 0.3; 95% CI: 0.2 to 0.7; P < 0.002) were independent predictors with the multivariate model.Conclusion Low T(3) levels are an independent predictor of mortality in patients with chronic heart failure, adding prognostic information to conventional clinical and functional cardiac parameters.
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“In particular, patients with reduced LV ejection fraction and low T 3 have higher mortality than patients with similar LV ejection fractions, but normal T 3 (134).”
From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [134]
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Cites
The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure
Pitt, B., Zannad, F., Remme, W. J., Cody, R., Castaigne, A., Perez, A., Palensky, J., & Wittes, J. (1999) · New England Journal of Medicine · doi:10.1056/nejm199909023411001 · Cited by 9,214
Plasma Norepinephrine as a Guide to Prognosis in Patients with Chronic Congestive Heart Failure
Cohn, J. N., Levine, T. B., Olivari, M. T., Garberg, V., Lura, D., Francis, G. S., Simon, A. B., & Rector, T. (1984) · New England Journal of Medicine · doi:10.1056/nejm198409273111303 · Cited by 3,125
Thyroid hormone and the cardiovascular system.
Klein, I., & Ojamaa, K. (2001) · New England Journal of Medicine · doi:10.1056/nejm200102153440707 · Cited by 2,300
Mechanisms and Models in Heart Failure
Mann, D. L. (1999) · Circulation · doi:10.1161/01.cir.100.9.999 · Cited by 769
Neurohormonal interactions and adaptations in congestive heart failure.
Packer, M. (1988) · Circulation · doi:10.1161/01.cir.77.4.721 · Cited by 537
Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease
Iervasi, G., Pingitore, A., Landi, P., Raciti, M., Ripoli, A., Scarlattini, M., L’Abbate, A., & Donato, L. (2003) · Circulation · doi:10.1161/01.cir.0000048124.64204.3f · Cited by 472
Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure
Koglin, J., Pehlivanli, S., Schwaiblmair, M., Vogeser, M., Cremer, P., & vonScheidt, W. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01672-2 · Cited by 404
Benedict, C. R., Shelton, B. J., Johnstone, D. E., Francis, G. S., Greenberg, B., Konstam, M. A., Probstfield, J. L., & Yusuf, S. (1996) · Circulation · doi:10.1161/01.cir.94.4.690 · Cited by 355
Safety and Hemodynamic Effects of Intravenous Triiodothyronine in Advanced Congestive Heart Failure
Hamilton, M. A., Stevenson, L. W., Fonarow, G. C., Steimle, A. E., Goldhaber, J. I., CHILD, J. S., CHOPRA, I. J., Moriguchi, J. D., & Hage, A. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00950-8 · Cited by 233
Altered thyroid hormone metabolism in advanced heart failure
Hamilton, M. A., Stevenson, L. W., Luu, M., & Walden, J. A. (1990) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(90)90462-x · Cited by 221
Research works printed but not linked: 3
- Klein, 1998, Thyroid hormone treatment of congestive heart failure, Am J Cardiol, 81, 490
- Di Pierro, 1996, Improved cardiac output and enhanced cardiac mechanical efficiency with acute administration of T3, Ann Thorac Surg, 62, 662
- Ghione, 1997, Circulating cathecolamines, Intern Med, 5, 93
Cited by
Sorted by citations
Klein, I., & Danzi, S. (2007) · Circulation · doi:10.1161/circulationaha.106.678326 · Cited by 1,324
Crespo-Leiro, M. G., Metra, M., Lund, L. H., Miličić, D., Costanzo, M. R., Filippatos, G. S., Gustafsson, F., Tsui, S. S. L., Barge‐Caballero, E., de Jonge, N., et al. (2018) · European Journal of Heart Failure · doi:10.1002/ejhf.1236 · Cited by 920
Thyroid hormones and cardiovascular disease
Jabbar, A., Pingitore, A., Pearce, S. H. S., Zaman, A., Iervasi, G., & Razvi, S. (2017) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.174 · Cited by 729
Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient
Stenvinkel, P., Carrero, J. J., Axelsson, J., Lindholm, B., Heimbürger, O., & Massy, Z. A. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.03670807 · Cited by 577
“Because low T3 levels are independent predictors of death in the general population (169,170), it has been suggested that decreased active thyroid hormone levels could be part of the deranged neuroendocrine/ proinflammatory system that is associated with CHF (171).”
BackgroundThyroid Hormones and Cardiovascular Function and Diseases
Razvi, S., Jabbar, A., Pingitore, A., Danzi, S., Biondi, B., Klein, I., Peeters, R., Zaman, A., & Iervasi, G. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.02.045 · Cited by 515
“In particular, patients with reduced LV ejection fraction and low T3 have higher mortality than patients with similar LV ejection fractions, but normal T3 (134).”
Background2020 Clinical practice guidelines for Chronic heart failure
Russian Society of Cardiology (2020) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2020-4083 · Cited by 553
MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction
Biondi, B. (2012) · European Journal of Endocrinology · doi:10.1530/eje-12-0627 · Cited by 291
Association between increased mortality and mild thyroid dysfunction in cardiac patients
Iervasi, G. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.14.1526 · Cited by 285
Self-citationPingitore, A., Galli, E., Barison, A., Iervasi, A., Scarlattini, M., Nucci, D., L’Abbate, A., Mariotti, R., & Iervasi, G. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2210 · Cited by 279
Treatment with thyroid hormone
Biondi, B., & Wartofsky, L. (2014) · Endocrine Reviews · doi:10.1210/er.2013-1083 · Cited by 259
Thyroid Dysfunction in Heart Failure and Cardiovascular Outcomes
Kannan, L., Shaw, P. A., Morley, M. P., Brandimarto, J., Fang, J. C., Sweitzer, N. K., Cappola, T. P., & Cappola, A. R. (2018) · Circulation: Heart Failure · doi:10.1161/circheartfailure.118.005266 · Cited by 245
Thyroid Replacement Therapy and Heart Failure
Gerdes, A. M., & Iervasi, G. (2010) · Circulation · doi:10.1161/circulationaha.109.917922 · Cited by 249
Carrero, J. J., Qureshi, A. R., Axelsson, J., Yılmaz, M. İ., Rehnmark, S., Witt, M. R., Barany, P. F., Heimbürger, O., Suliman, M. E., Alvestrand, A., et al. (2007) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2007.01865.x · Cited by 190
Low triiodothyronine and survival in end-stage renal disease
Zoccali, C., Mallamaci, F., Tripepi, G. L., Cutrupi, S., & Pizzini, P. (2006) · Kidney International · doi:10.1038/sj.ki.5001566 · Cited by 189
III Diretriz Brasileira de Insuficiência Cardíaca Crônica
Bocchi, E. A., Marcondes‐Braga, F. G., Ayub‐Ferreira, S. M., Rohde, L. E. P., Junior, W. A. D. O., Almeida, D. R., Moreira, M. D. C. V., Bestetti, R. B., Bordignon, S., Azevedo, C., et al. (2009) · Americanae (AECID Library) · doi:10.1590/s0066-782x2009002000001 · Cited by 170
Lee, S. Y., & Farwell, A. P. (2016) · Comprehensive physiology · doi:10.1002/cphy.c150017 · Cited by 178
Thyroid function during critical illness
Economidou, F. N., Douka, E., Tzanela, M., Nanas, S., & Kotanidou, A. N. (2011) · HORMONES · doi:10.14310/horm.2002.1301 · Cited by 155
The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence
Galli, E., Pingitore, A., & Iervasi, G. (2010) · Heart Failure Reviews · doi:10.1007/s10741-008-9126-6 · Cited by 132
“[13] Heart Fail Rev (2010) 15:155–169 163”
BackgroundInfluentialThyroid Hormone Plays an Important Role in Cardiac Function: From Bench to Bedside
Yamakawa, H., Kato, T., Noh, J. Y., Yuasa, S., Kawamura, A., Fukuda, K., & Aizawa, Y. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.606931 · Cited by 137
Pantos, C. I., Mourouzis, I. S., Markakis, K. P., Tsagoulis, N., Panagiotou, M., & Cokkinos, D. V. (2008) · Basic Research in Cardiology · doi:10.1007/s00395-008-0697-0 · Cited by 120
“Furthermore, the circulating T3 in plasma is often found to be low in patients with heart failure and is strongly correlated with cardiac dysfunction and increased mortality [23, 38, 39 ].”
BackgroundPol, C. J., Muller, A., Zuidwijk, M. J., van Deel, E. D., Kaptein, E., Saba, A., Marchini, M., Zucchi, R., Visser, T. J., Paulus, W. J., et al. (2010) · Endocrinology · doi:10.1210/en.2010-0431 · Cited by 102
“LV weight/TL (mg/cm) Sham 51 2 (10) 51 2 (9) 49 1 (11) MI 52 7 (9) 55 3 (11) 57 3 (13) RV weight/TL (mg/cm) Sham 13 1 (10) 13 1 (9) 12 1 (11) MI 15 1 (9) 23 2 (11) 17 1 (13) Lung wet/dry ratio Sham 4.”
InfluentialFarwell, A. P. (2013) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/01.med.0000433069.09294.e8 · Cited by 100
“Unau 1752-296X 2013 Wolters Kluwer Health | Lippincott Williams & Wilki heart failure [34,35,56].”
BackgroundForini, F., Lionetti, V., Ardehali, H., Pucci, A., Cecchetti, F., Ghanefar, M., Nicolini, G., Ichikawa, Y., Nannipieri, M., Recchia, F. A., et al. (2011) · Journal of Cellular and Molecular Medicine · doi:10.1111/j.1582-4934.2010.01014.x · Cited by 98
“We have previously reported that circulating FT3 levels in patients with ischemic HF were progressively reduced in relation to disease severity [1, 40].”
BackgroundHeart Failure as a Multiple Hormonal Deficiency Syndrome
Saccà, L. (2009) · Circulation Heart Failure · doi:10.1161/circheartfailure.108.821892 · Cited by 94
Wang, B., Liu, S., Li, L., Yao, Q., Song, R., Shao, X., Li, Q., Shi, X., & Zhang, J. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.10.039 · Cited by 98
“Pingitore A 2005 [53] Prospective Italy (1998–2001) 281 patients with dilated cardiomyopathy(66 years; 29%) 173 (low fT3 level) Yes NR During 2 to 5 days after hospital admission 12 months Prevalence, all-cause mortality None 5”
2020 Clinical practice guidelines for Chronic heart failure
Russian Society of Cardiology (2020) · Russian Journal of Cardiology · doi:10.15829/29/1560-4071-2020-4083 · Cited by 88
Lymvaios, I., Mourouzis, I., Cokkinos, D. V., Dimopoulos, M. A., Toumanidis, S. T., & Pantos, C. (2011) · European Journal of Endocrinology · doi:10.1530/eje-11-0062 · Cited by 87
Thyroid hormone and heart failure
Schmidt-Ott, U., & Ascheim, D. D. (2006) · Current Heart Failure Reports · doi:10.1007/s11897-006-0010-1 · Cited by 85
The impact of thyroid hormone dysfunction on ischemic heart disease
von Hafe, M., Neves, J. S., Vale, C., Borges‐Canha, M., & Leite-Moreira, A. F. (2019) · Endocrine Connections · doi:10.1530/ec-19-0096 · Cited by 87
The Role of Thyroid Hormones in Heart Failure
Vale, C., Neves, J. S., von Hafe, M., Borges‐Canha, M., & Leite-Moreira, A. F. (2019) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-019-06870-4 · Cited by 78
Vargas, F., Rodríguez‐Gómez, I., Vargas-Tendero, P., Jiménez, E. G., & Montiel, M. (2011) · Journal of Endocrinology · doi:10.1530/joe-11-0349 · Cited by 74
“…subclinical thyroid disorders Changes in thyroid function parameters are observed in starvation and fasting, cardiac disease (Kozdag et al. 2005, Pingitore et al. 2005), renal disease (Lim et al. 1980, Zoccali et al. 2005), renal transplantation (Hekmat et al. 2010), ageing (Tognini et al.…”
BackgroundPingitore, A., Iervasi, G., Barison, A., Prontera, C., Pratali, L., Emdin, M., Giannessi, D., & Neglia, D. (2006) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2006.05.009 · Cited by 67
Low triiodothyronine and cardiomyopathy in patients with end-stage renal disease
Zoccali, C., Benedetto, F., Mallamaci, F., Tripepi, G. L., Cutrupi, S., Pizzini, P., Malatino, L., Bonanno, G., & Seminara, G. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000244954.62362.8f · Cited by 68
Pantos, C. I., Dritsas, A., Mourouzis, I. S., Dimopoulos, A., Καρατασάκης, Γ., Athanasopoulos, G., Mavrogeni, S. I., Manginas, A. N., & Cokkinos, D. V. (2007) · European Journal of Endocrinology · doi:10.1530/eje-07-0318 · Cited by 63
“We measured only the total T3, which in previous experimental and clinical studies has been mostly associated with increased mortality and impaired cardiac function ( 5 , 10).”
BackgroundMourouzis, I. S., Mantzouratou, P., Galanopoulos, G. T., Kostakou, E., Roukounakis, N., Kokkinos, A. D., Cokkinos, D. V., & Pantos, C. I. (2011) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-011-1175-9 · Cited by 61
“TH levels are decreased after acute myocardial infarction [3, 4], in cardiac operations [5] and in heart failure [6].”
BackgroundThyroid Status, Cardiac Function, and Mortality in Patients With Idiopathic Dilated Cardiomyopathy
Wang, W., Guan, H., Gerdes, A. M., Iervasi, G., Yang, Y., & Tang, Y. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-4159 · Cited by 60
Pingitore, A., Mastorci, F., Piaggi, P., Aquaro, G. D., Molinaro, S., Ravani, M., Caterina, A. D., Trianni, G., Ndreu, R., Berti, S. L., et al. (2018) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2018.12.020 · Cited by 61
A low fT3 level as a prognostic marker in patients with acute myocardial infarctions
Zhang, B., Peng, W., Wang, C., Li, W., & Xu, Y. (2012) · Internal Medicine · doi:10.2169/internalmedicine.51.7902 · Cited by 59
“Accumulating evidence suggests that a low fT3 level is a strong predictor of a poor prognosis in patients with chronic cardiovascular diseases, including stable angina pectoris (9), chronic heart failure (10) and so on (11).”
BackgroundSchwartz, E., & Holtorf, K. (2008) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2008.07.015 · Cited by 59
Thyroid hormone and “cardiac metamorphosis”: Potential therapeutic implications
Pantos, C. I., Mourouzis, I. S., Xinaris, C., Papadopoulou-Daifoti, Z., & Cokkinos, D. V. (2008) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2008.02.011 · Cited by 58
Brožaitienė, J., Mickuvienė, N., Podlipskytė, A., Burkauskas, J., & Bunevičius, R. (2016) · BMC Cardiovascular Disorders · doi:10.1186/s12872-016-0226-2 · Cited by 60
“disturbed T4 peripheral conversion, such as a reduction in circulating levels of T3 [18, 39, 40], low T3 syndrome [19, 41–44], mild changes of fT4 [45], a high rT3 level [46], a low fT3/rT3 ratio [46] and a low fT3/fT4 ratio in serum [45].”
BackgroundThe Effect of Thyroid Function on Clinical Outcome in Patients with Heart Failure
Chen, S., Shauer, A., Zwas, D. R., Lotan, C., Keren, A., & Gotsman, I. (2013) · European Journal of Heart Failure · doi:10.1002/ejhf.42 · Cited by 56
Pantos, C. I., Xinaris, C., Mourouzis, I. S., Malliopoulou, V., Kardami, E., & Cokkinos, D. V. (2006) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-006-9323-3 · Cited by 56
“Accordingly, in patients with post-ischemic dilated cardiomyopathy, low thyroid hormone levels were found to be an independent predictor of mortality [3].”
BackgroundRothberger, G. D., Gadhvi, S., Michelakis, N., Kumar, A., Calixte, R., & Shapiro, L. E. (2017) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.10.045 · Cited by 56
Passino, C., Pingitore, A., Landi, P., Fontana, M., Zyw, L., Clerico, A., Emdin, M., & Iervasi, G. (2008) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2008.08.008 · Cited by 54
Dhingra, S., & Bansal, M. P. (2006) · Chemico-Biological Interactions · doi:10.1016/j.cbi.2006.02.008 · Cited by 52
Acute Effects of Triiodothyronine on Endothelial Function in Human Subjects
Napoli, R., Guardasole, V., Angelini, V., Zarra, E., Terracciano, D., D’Anna, C., Matarazzo, M., Oliviero, U., Macchia, V., & Saccà, L. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1552 · Cited by 51
Özcan, K. S., Osmonov, D., Toprak, E., Güngör, B., Tatlısu, A., Ekmekçi, A., Kaya, A., Tayyareci, G., & Erdinler, İ. (2014) · Cardiology Journal · doi:10.5603/cj.a2013.0108 · Cited by 50
“It is related to increased mortality in both heart failure and AMI [10–14].”
BackgroundSelvaraj, S., Klein, I. L., Danzi, S. E., Akhter, N., Bonow, R. O., & Shah, S. J. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.02.068 · Cited by 50
Pingitore, A., Chen, Y., Gerdes, A. M., & Iervasi, G. (2011) · Annals of Medicine · doi:10.3109/07853890.2011.573501 · Cited by 47
Chuang, C.-P., Jong, Y.-S., Wu, C.-Y., & Lo, H. (2013) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2013.11.039 · Cited by 48
Identification of New Prognostic Factors of Pulmonary Hypertension
Miura, Y., Fukumoto, Y., Sugimura, K., Oikawa, M., Nakano, M., Tatebe, S., Miyamichi-Yamamoto, S., Satoh, K., & Shimokawa, H. (2010) · Circulation Journal · doi:10.1253/circj.cj-10-0270 · Cited by 47
Induction of Type 1 Iodothyronine Deiodinase to Prevent the Nonthyroidal Illness Syndrome in Mice
Yu, J., & Koenig, R. J. (2006) · Endocrinology · doi:10.1210/en.2005-1443 · Cited by 46
Thyroid Dysfunction and Heart Failure: Mechanisms and Associations
Vargas‐Uricoechea, H., & Bonelo, A. (2017) · Current Heart Failure Reports · doi:10.1007/s11897-017-0312-5 · Cited by 47
Farwell, A. P. (2008) · Endocrine Practice · doi:10.4158/ep.14.9.1180 · Cited by 45
Rotondi, M., Netti, G. S., Rosati, A., Mazzinghi, B., Magri, F., Ronconi, E., Becherucci, F., Pradella, F., Salvadori, M., Serio, M., et al. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.03022.x · Cited by 45
Thyroid hormone and cardiovascular system: from basic concepts to clinical application
Iervasi, G., & Nicolini, G. (2013) · Internal and Emergency Medicine · doi:10.1007/s11739-013-0911-4 · Cited by 45
Belke, D. D., Gloss, B. R., Swanson, E. A., & DILLMANN, W. H. (2007) · Endocrinology · doi:10.1210/en.2007-0009 · Cited by 44
“ings have shown that low T3 levels are a predictor of mortality in patients with heart failure (26).”
BackgroundPantos, C. I., Mourouzis, I. S., Tsagoulis, N., Markakis, K., Galanopoulos, G. T., Roukounakis, N., Perimenis, P., Liappas, A., & Cokkinos, D. V. (2009) · PubMed · Cited by 44
Thyroid Hormone and Cardiac Disease: From Basic Concepts to Clinical Application
Mourouzis, I. S., Forini, F., Pantos, C. I., & Iervasi, G. (2011) · Journal of Thyroid Research · doi:10.4061/2011/958626 · Cited by 44
“The low-T3 syndrome occurs in approximately 20– 30% of patients with heart failure [42–44] with significantly higher incidence in patients with NYHA functional class IIIIV than in those with NYHA I-II [43, 45].”
BackgroundAmin, A., Chitsazan, M., Taghavi, S., & Ardeshiri, M. (2015) · ESC Heart Failure · doi:10.1002/ehf2.12025 · Cited by 43
“Several clinical observational studies have shown that LT3S adversely affects long-term prognosis in HF and found it as an independent predictor of death in this population, even independently of NT-proBNP and other cardiovascular risk factors.(7,18,19) A number of structural and functional abnormalities have been rec…”
BackgroundThe association between thyroid hormones and arterial stiffness in peritoneal dialysis patients
Tatar, E., Demirci, M. S., Kırçelli, F., Güngör, Ö., Yaprak, M., Aşçı, G., Başçı, A., Özkahya, M., & Ok, E. (2011) · International Urology and Nephrology · doi:10.1007/s11255-011-0034-7 · Cited by 43
“Importantly, overt hypothyroidism, subclinical hypothyroidism and low fT3/T3 are associated with cardiovascular outcomes in the general population [12–15].”
BackgroundPersistence of Mortality Risk in Patients With Acute Cardiac Diseases and Mild Thyroid Dysfunction
Molinaro, S., Iervasi, G., Lorenzoni, V., Landi, P., Srebot, V., Mariani, F., Pingitore, A., L’Abbate, A., & Coceani, M. A. (2011) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e31822846bd · Cited by 43
Thyroid hormones and heart failure
Martínez, F. A. (2016) · Heart Failure Reviews · doi:10.1007/s10741-016-9556-5 · Cited by 43
“T3 is an independent predictor of cardiac mortality [13].”
BackgroundPantos, C. I., Mourouzis, I. S., Xinaris, C., Kokkinos, A. D., Markakis, K., Dimopoulos, A. D., Panagiotou, M., Saranteas, T., Kostopanagiotou, G. G., & Cokkinos, D. V. (2007) · European Journal of Endocrinology · doi:10.1530/eje-06-0707 · Cited by 42
“Furthermore, in overt heart failure, low TH levels have been associated with increased mortality ( 2 ).”
BackgroundThyroid Hormone and Cardioprotection
Gerdes, A. M., & Ojamaa, K. (2016) · Comprehensive physiology · doi:10.1002/cphy.c150012 · Cited by 45
Thyroid hormones in extreme longevity
Garasto, S., Montesanto, A., Corsonello, A., Lattanzio, F., Fusco, S., Passarino, G., Giarritta, V. P., & Corica, F. (2017) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2017.03.002 · Cited by 41
Thyroid Hormone Levels Predict Mortality in Intensive Care Patients With Cirrhosis
Taş, A., Köklü, S., Beyazıt, Y., Kurt, M., Sayılır, A., Yeşil, Y., & Çelik, H. (2011) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e318239a666 · Cited by 40
Hypercholesterolemia and LDL receptor mRNA expression: modulation by selenium supplementation
Dhingra, S., & Bansal, M. P. (2006) · BioMetals · doi:10.1007/s10534-005-5393-z · Cited by 38
“Involvement of thyroid hormones in cardiovascular system is also an established fact now (Pingitore et al. 2005).”
BackgroundPantos, C. I., & Mourouzis, I. S. (2014) · Heart Failure Reviews · doi:10.1007/s10741-014-9465-4 · Cited by 36
“Along this line, low total T3 levels in patients with chronic heart failure (postischemic and non-ischemic dilated cardiomyopathy) are also an independent predictor of cardiac mortality [16].”
BackgroundJanssen, R., Zuidwijk, M. J., Kuster, D. W. D., Muller, A., & Simonides, W. S. (2014) · Frontiers in Endocrinology · doi:10.3389/fendo.2014.00171 · Cited by 37
“Clinical studies have shown that the extent of the reduction is an independent predictor of mortality in patients with chronic heart failure (87, 88).”
BackgroundMetabolic Syndrome, Thyroid Dysfunction, and Cardiovascular Risk: The Triptych of Evil
Pingitore, A., Gaggini, M., Mastorci, F., Sabatino, L., Cordiviola, L., & Vassalle, C. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms251910628 · Cited by 39
“In the context of heart failure and acute myocardial infarction, an abnormal TH profile has been associated with a high prevalence of major cardiac event, representing an independent predictor of cardiac death in addition to the common clinical and cardiac functional parameters [27,28].”
BackgroundOkayama, D., Minami, Y., Kataoka, S., Shiga, T., & Hagiwara, N. (2015) · Journal of Cardiology · doi:10.1016/j.jjcc.2015.04.006 · Cited by 36
“However, the relationship between thyroid dysfunction and clinical outcomes in patients with established chronic heart failure remains controversial [14,16–18,20,23].”
BackgroundInfluentialBunevičius, R., Varoneckas, G., Prange, A. J., Hinderliter, A. L., Gintauskienė, V. M., & Girdler, S. S. (2006) · Clinical Cardiology · doi:10.1002/clc.4960290409 · Cited by 35
Endocrine system dysfunction and chronic heart failure: a clinical perspective
Lisco, G., Giagulli, V. A., Iovino, M., Zupo, R., Guastamacchia, E., Pergola, G. D., Iacoviello, M., & Triggiani, V. (2021) · Endocrine · doi:10.1007/s12020-021-02912-w · Cited by 34
Xu, G., Yan, W., & Li, J. (2014) · Clinical and Experimental Nephrology · doi:10.1007/s10157-014-0974-1 · Cited by 33
Hypothyroidism: Cardiovascular Endpoints of Thyroid Hormone Replacement
Stamatouli, A. M., Bedoya, P., & Yavuz, S. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00888 · Cited by 34
“Their neuroendocrine profile significantly improved (heart rate, BNP, aldosterone and nor-adrenaline levels all decreased) and the ventricular performance increased (72).”
BackgroundPantos, C. I., Mourouzis, I. S., & Cokkinos, D. V. (2009) · Vascular Pharmacology · doi:10.1016/j.vph.2009.11.006 · Cited by 30
The relationship and prognostic impact of low-T3 syndrome and NT-pro-BNP in cardiovascular patients
Pfister, R., Strack, N., Wielckens, K., Malchau, G., Erdmann, E., & Schneider, C. A. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.03.137 · Cited by 27
“In patients with heart failure, the low-T3 syndrome especially correlates with disease severity and is independently associated with unfavourable prognosis [5].”
BackgroundDoes Depression Impact Cognitive Impairment in Patients with Heart Failure?
Sohani, Z. N., & Samaan, Z. (2012) · Cardiology Research and Practice · doi:10.1155/2012/524325 · Cited by 30
“[69] A.”
BackgroundCardioprotection and Thyroid Hormones in the Clinical Setting of Heart Failure
Mastorci, F., Sabatino, L., Vassalle, C., & Pingitore, A. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00927 · Cited by 24
“This finding indicates that LT3S is an independent predictor of mortality, adding prognostic information to conventional clinical and functional cardiac parameters, such as left ventricular ejection fraction (22).”
BackgroundThyroid Disorders in Chronic Heart Failure: From Prognostic Set-up to Therapeutic Management
Triggiani, V., & Iacoviello, M. (2013) · Endocrine Metabolic & Immune Disorders - Drug Targets · doi:10.2174/1871530311313010005 · Cited by 25
Multimarker approach for heart failure management: Perspectives and limitations
Giannessi, D. (2011) · Pharmacological Research · doi:10.1016/j.phrs.2011.03.006 · Cited by 26
“[73] is based on the observation that alterations of thyroid function are present in HF patients without primary thyroid disease [79,80].”
BackgroundFatigue in Patients With Coronary Artery Disease
Bunevičius, A., Gintauskienė, V. M., Podlipskytė, A., Žaliūnas, R., Brožaitienė, J., Prange, A. J., & Bunevičius, R. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318268e7f0 · Cited by 25
“After acute cardiac events such as MI (17) or heart failure (33,34), thyroid hormone concentrations, especially T3 concentrations, usually decrease, causing the so-called low T3 syndrome.”
BackgroundEinfeldt, M. N., Olsen, A. S., Kristensen, S. L., Khalid, U., Faber, J. O., Torp-Pedersen, C. T., Gislason, G., & Selmer, C. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-01604 · Cited by 23
Low triiodothyronine and exercise capacity in heart failure
Fontana, M., Passino, C., Poletti, R., Zyw, L., Prontera, C., Scarlattini, M., Clerico, A., Emdin, M., & Iervasi, G. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.09.002 · Cited by 22
“triiodothyronine (T3) syndrome”, has been reported in approximately 30% of patients with advanced HF and its presence is an independent predictor of death [7–11].”
BackgroundThe relationship of thyroid hormone status with myocardial function in stress cardiomyopathy
Lee, S. J., Kang, J. G., Ryu, O. H., Kim, C. S., Ihm, S., Choi, M. G., Yoo, H. J., & Hong, K. S. (2009) · European Journal of Endocrinology · doi:10.1530/eje-08-0808 · Cited by 22
Hypothyroidism, atherosclerosis and cardiovascular risk prevention
Duntas, L. H., & Feldt‐Rasmussen, U. (2025) · Nature Reviews Endocrinology · doi:10.1038/s41574-025-01202-z · Cited by 22
The Management of Thyroid Abnormalities in Chronic Heart Failure
Biondi, B. (2019) · Heart Failure Clinics · doi:10.1016/j.hfc.2019.02.008 · Cited by 20
Kim, D. H., Choi, D.-H., Kim, H., Choi, S.-W., Kim, B.-B., Chung, J., Koh, Y. Y., Chang, K., & Hong, S. (2014) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2014.29.4.454 · Cited by 20
Shi, C., Bao, Y., Chen, X., & Tian, L. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.07.004 · Cited by 20
Koo, H. M., Kim, C. H., Doh, F. M., Lee, M. J., Kim, E. J., Han, J. H., Han, J. S., Oh, H. J., Han, S. H., Yoo, T., et al. (2013) · European Journal of Endocrinology · doi:10.1530/eje-13-0540 · Cited by 19
Lee, S. Y., & Farwell, A. P. (2016) · Comprehensive physiology · doi:10.1002/j.2040-4603.2016.tb00695.x · Cited by 21
“Low free T3 and high rT3 levels have also been associated with increased risk for mortality in patients in the intensive care unit (ICU) (89, 105), hospitalized cardiac patients (82), patients with congestive heart failure (CHF) (40, 92) and patients with liver cirrhosis (34).”
Thyroid Hormone and Heart Failure: Charting Known Pathways for Cardiac Repair/Regeneration
Mantzouratou, P., Malaxianaki, E., Cerullo, D., Lavecchia, A. M., Pantos, C. I., Xinaris, C., & Mourouzis, I. S. (2023) · Biomedicines · doi:10.3390/biomedicines11030975 · Cited by 18
“also showed that low T3 levels are an independent predictor of mortality [39].”
BackgroundHolndonner-Kirst, E., Nagy, Á., Czobor, N. R., Fazekas, L., Dohán, O., Kertai, M. D., Lex, D. J., Sax, B., Hartyánszky, I. L., Merkely, B. P., et al. (2018) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.10.024 · Cited by 18
The Cardiovascular Effects Of Hyperthyroidism
Nabbout, L. A.-K., & Robbins, R. J. (2010) · Methodist DeBakey Cardiovascular Journal · doi:10.14797/mdcj-6-2-3 · Cited by 26
“33 This has led to clinical trials addressing the efficacy of thyroid hormone replacement therapy in patients with heart failure.”
Thyroid Disorders and Prognosis in Chronic Heart Failure: A Long-Term Follow-Up Study
Iacoviello, M., Parisi, G., Gioia, M. I., Grande, D., Rizzo, C., Guida, P., Lisi, F., Giagulli, V. A., Licchelli, B., Serio, F. D., et al. (2019) · Endocrine Metabolic & Immune Disorders - Drug Targets · doi:10.2174/1871530319666191018134524 · Cited by 17
Kozdağ, G., Ertaş, G., Aygün, F., Emre, E., Kirbas, A., Ural, D., & Soran, O. Z. (2012) · The Anatolian Journal of Cardiology · doi:10.5152/akd.2012.064 · Cited by 17
Frączek-Jucha, M. M., Zbierska-Rubinkiewicz, K., Kabat, M., Plens, K., Rychlak, R., Nessler, J. M., & Gackowski, A. (2019) · BMC Cardiovascular Disorders · doi:10.1186/s12872-019-1076-5 · Cited by 17
An, S., Gilani, N., Huang, Y., Muncan, A., Zhang, Y., Tang, Y., Gerdes, A. M., & Ojamaa, K. (2019) · Molecular Medicine · doi:10.1186/s10020-019-0120-3 · Cited by 17
Metadata
- Authors
- Pingitore, A., Landi, P., Taddei, M. C., Ripoli, A., L’Abbate, A., & Iervasi, G.
- Affiliations
- Istituto di Fisiologia Clinica (IT)
- Scuola Superiore Sant'Anna (IT)
- Corresponding author
- Pingitore, Alessandro
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2005-02
- Volume
- 118
- Issue
- 2
- Pages
- 132-136
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2171564744
- Cited by
- 192
- References
- 25
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 9 · 2020: 12 · 2019: 11 · 2018: 9 · 2017: 10 · 2016: 10 · 2015: 10 · 2014: 6 · 2013: 9 · 2012: 9
- FWCI
- 7.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion, other-oa)
- JAMA
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- triiodothyronine, free triiodothyronine, chronic heart failure, dilated cardiomyopathy, risk stratification, prognosis, all-cause mortality, cardiac mortality, ejection fraction, thyroid hormones, non-ischemic cardiomyopathy, prognostic factors, multivariate risk models, NYHA functional class, NT-proBNP
- MeSH terms
- Aged, Aged, 80 and over, Chronic Disease, Female, Heart Failure, Humans, Male, Middle Aged, Prognosis, Stroke Volume, Triiodothyronine, Biomarkers, Multivariate Analysis, Survival Analysis, Myocardial Ischemia, Risk Assessment
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