| INTRODUCTIONThyroid hormone has multiple effects on the cardiovascular systems, and they also regulate biochemical reaction in most tissues. Recently,it has been observed that thyroid hormone level abnormalities commonly exist in patiens with congestive heart failure . some studies abroad have showed low triiodothyronine ( T3) levels, and normal thyroxine ( T4 ) as well as thyroid - stimulating hormone (TSH)in patiens with congestive heart failure. The low triiodothyronine (T3) level is associated with disease severity in patiens with congestive heart failure which seems to be a marker of severity. The lower triiodothyronine is, the more serious disease situation is, therefore, thyroid hormone measurement is useful for risk stratification of patiens with congestive heart failure. The change of Thyroid hormone levels may be particularly significant for assessing the evolution and prognosis in patients with congestive heart failure. Small dose of Thyroid hormone supplementary treatment in patients with congestive heart failure on the basis of conditional treatment may be useful and shorten process of congestive heart failure, this method is likely to become a new method of treatment in patients with congestive heart failure.MATERIALS AND METHODSMaterialsWe enrolled a total of 56 hospitalized patients with congestive heart failure, 14cases of NYHA â…¡ class, 24cases of NYHA â…¢ class and 18cases of NYHAIV class. The control group 34cases,which consisted of healthy normal subjects. Patients with congestive heart failure who had indicated change of thyroid hormone were random divided into the observation group (20cases) and the treatment group (22cases). Two groups matched mutually for age and sex.MethodsVenous blood was drawn after an overnight fast. Serum thyriod hormones: total triiodothyronine (T3) , free triiodothyronine ( FT3) ,thyroxine (T4) ,free thyroxine (FT4) as well as thyroid -stimulating hormone (TSH) were measured in patients with congestive heart failure and normal subjects by radioimmunology . The observation group were treated with conventional methods, the treatment group were treated with conventional methods and thyroxine20ug every morning was added for 4 weeks. The serum thyriod hormones were examined after treatment, and cardiac function parameters were examined by Echocardiography before and after treatment.Statistical analysisStatistical analysis were done using SPSS 10. 0 Statistical software. Results were expressed as means standard deviation . Comparison between 2 groups was tested By Student Newman Keul t test, P values less than 0.05 were considered to be significant . Analysis of variance (ANVOA) was performed among comparison of many groups, P values less than 0. 05were considered to be significant, and P values less than 0.01 were considered to be highly significant.RESULTS1. Comparison of thyriod hormone levels between patients with congestive heart failure and control subjects . Serum T3, FT3 levels were significantly lower in patients with congestive heart failure than those in control subjects , P < 0.05. The levels of T4, FT4, TSH were normal , which had no significant difference between two groups ,P> 0.05.2. Relation of cardiac function in patients with congestive heart failure and the levels of thyriod hormone . The different degree of congestive heart failure had The difference of T3 ,FT3 levels . The lower T3 ,FT3 levels were, the moreserious degree of congestive heart failure is , which had significant difference , P<0.05 orP<0.01.3. Change of thyriod hormone levels of the treatment group and the observation group before and after treatment . After 4 weeks of thyriod hormone treatment in the treatment group ,T3,Fr3 levels significantly increased ,which had significant difference comparing those before treatment , P < 0.05, and also had significant difference comparing those after treatment in the observation group, P<0.05. The levels of T4, FT4, and TSH were normal , which had no significant difference, P>0.05.4. Comparison of cardiac function parameters of the treatment group and the observation group before and after treatment. After 4 weeks of thyriod hormone treatment in the treatment group, compared those before treatment, cardiac function parameters had obvious improvement, P <0.05, and also had significant difference compared those after treatment in the observation group, P < 0.05.CONCLUSION1. This study indicates that the Serum T3, FT3 levels were significantly lower in patients with congestive heart failure. The lower T3, FT3 levels were , the more serious degree of congestive heart failure was, therefore, the change of Thyroid hormone levels may be particularly helpful for assessing the evolution and prognosis in patients with congestive heart failure.2. When the levels of serum T3 ,FT3are significantly lower in patients with congestive heart failure small dose of Thyroid hormone supplementary treatment is useful for patients with congestive heart failure and shortens process of congestive heart failure on the basis of conventional methods of treatment. This method may become a new method of treatment in patients with congestive heart failure.
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