2012


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2012/№3

Impact of hormone-replacement therapy on vascular wall function in patients with heart failure and sub-clinical hypothyroidism

Blankova Z. N., Seredinina E. M., Kulev B. D., Ryabtseva O. Y., Svirida O. N, Zhubrina E. S., Barinova I. V., Ageev F. T.
Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: hypotheriosis, vessels, therapy, CHF

DOI: 10.18087 / rhfj.2012.3.1655

Relevance. Currently researchers pay great attention to endothelial dysfunction and vascular stiffness in CHF patients. Subclinical hypotheriosis is associated with similar vascular lesion whereas the necessity of its hormone replacement therapy (HRT) is discussed by experts. Objective. To evaluate effect of HRT by Levothyroxin on arterial pressure, vascular rigidity, endothelial function in CHF patients with preserved ejection f unction (CHF-PEF) in a combination with subclinical hypotheriosis. Materials and methods. 43 patients with CHF in a combination with subclinical hypotheriosis, with diastolic dysfunction according to data of Doppler EchoCG in a stable state (NYHA II), taking standard CHF therapy, were randomized in two groups. Patients of Group I received standard CHF therapy and Levothyroxin (average dosage 60 mcg) and completed study on achevement of euthyreosis (thyreotropic hormone – 2.3±1 mU per l) in 6–10 months. Group I patients received only standard CHF therapy and completed study in 6 months. At the initial point and at the final visit arterial pressure, brachial-ankle and carotid-femoral speeds of pulse wave and endothelial function were evaluated for each patient. Results. Levothyroxin hormone replacement therapy led to statistically reliable reduction of systolic pressure (132±15 / 121±13 mm Hg, p<0.01), diastolic pressure (81±10 / 75±9 mm Hg, p<0.01) and brachial-ankle SPW (14.3±2.2 / 13.5±1.4 m per sec, p<0.01) and improvement of endothelial f unction (flow-dependent vasodilatation 7.8±4.1,%, p<0.001). No reliable changes of studied parameters in Group II were observed. Conclusion. In CHF – PEF patients combined with subclinical hypotheriosis, Levothyroxin HRT increases arterial stiffness, endothelial function and reduces arterial pressure.
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Blankova Z. N., Seredinina E. M., Kulev B. D. et al. Impact of hormone-replacement therapy on vascular wall function in patients with heart failure and sub-clinical hypothyroidism. Russian Heart Failure Journal. 2012;13(3):167-171

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