Prognostic role of sub-clinical hypothyroidism in chronic heart failure outpatients
Abstract
BACKGROUND: It has been suggested that low thyroid hormones levels may be associated with increased mortality in patients with cardiovascular disease. AIM: To evaluate the prognostic role of thyroid function deficiency in patients with chronic heart failure (CHF). METHODS: We evaluated 338 consecutive outpatients with stable CHF receiving conventional therapy, all of whom underwent a physical examination, electrocardiography and echocardiography. Blood samples were drawn to assess renal function, and Na+, hemoglobin, NT-proBNPs, fT3, fT4 and TSH levels. Patients with hyperthyroidism were excluded. RESULTS: During the follow-up (15+/-8 months), heart failure progression was observed in 79 patients (including 18 who died of heart failure after hospitalisation and six who underwent transplantation). Univariate regression analysis showed that TSH (p<0.0001), fT3 (p<0.0001), fT4 (p=0.016) and fT3/fT4 (p<0.0001) were associated with heart failure progression but multivariate analysis showed that only TSH considered as a continuous variable (p = 0.001) as well as subclinical hypothyroidism (TSH > 5.5 mUI/l; p=0.014) remained significantly associated with the events. CONCLUSIONS: In CHF patients TSH levels even slightly above normal range are independently associated with a greater likelihood of heart failure progression. This supports the need for prospective studies aimed at clarifying the most appropriate therapeutic approach to sub-clinical hypothyroidism in such patients.
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In patients with chronic heart failure, nonthyroidal illness has been associated with a worse prognosis.
“in patients with chronic HF, NTI has been associated with a worse prognosis (96,124,125).”
From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [124]
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Ma, L., Gou, M., Liu, X., Ding, L., & Ma, C. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1652749 · Cited by 1 · see citing works
- Authors
- Iacoviello, M., Guida, P., Guastamacchia, E., Triggiani, V., Forleo, C., Catanzaro, R., Cicala, M., Basile, M., Sorrentino, S., & Favale, S.
- Affiliations
- University of Bari Aldo Moro (IT)
- Istituti Clinici Scientifici Maugeri (IT)
- ORCID
- Venue
- Current Pharmaceutical Design
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2008-09-01
- Volume
- 14
- Issue
- 26
- Pages
- 2686-2092
- ISSN
- 1381-6128 (ISSN-L)
- OpenAlex
- W2140750915
- Cited by
- 82
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 4 · 2021: 3 · 2020: 7 · 2019: 10 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 9 · 2012: 6
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Pharmaceutical Design (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- subclinical hypothyroidism, chronic heart failure, thyroid-stimulating hormone, thyroid function, heart failure progression, prognosis, free thyroxine, free triiodothyronine, NT-proBNP, outpatients
- MeSH terms
- Aged, Chronic Disease, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Failure, Humans, Hypothyroidism, Male, Middle Aged, Predictive Value of Tests, Prognosis, Regression Analysis, Thyroid Function Tests, Thyrotropin, Thyroxine, Triiodothyronine, Disease Progression
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