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Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure

BACKGROUND: Hypothyroidism is known to be associated with adverse clinical outcomes in heart failure. The association between hypothyroidism and cardiac resynchronization therapy outcomes in patients with severe heart failure is not clear. METHODS: The study included 1316 patients who received cardi...

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Autores principales: Yang, Mei, Li, Xuping, Morris, John C., Liang, Jinjun, Deshmukh, Abhishek J., Hodge, David, Li, Yigang, Cha, Yong-Mei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509921/
https://www.ncbi.nlm.nih.gov/pubmed/32967613
http://dx.doi.org/10.1186/s12872-020-01693-w
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author Yang, Mei
Li, Xuping
Morris, John C.
Liang, Jinjun
Deshmukh, Abhishek J.
Hodge, David
Li, Yigang
Cha, Yong-Mei
author_facet Yang, Mei
Li, Xuping
Morris, John C.
Liang, Jinjun
Deshmukh, Abhishek J.
Hodge, David
Li, Yigang
Cha, Yong-Mei
author_sort Yang, Mei
collection PubMed
description BACKGROUND: Hypothyroidism is known to be associated with adverse clinical outcomes in heart failure. The association between hypothyroidism and cardiac resynchronization therapy outcomes in patients with severe heart failure is not clear. METHODS: The study included 1316 patients who received cardiac resynchronization therapy between 2002 and 2015. Baseline demographics and cardiac resynchronization therapy outcomes, including left ventricular ejection fraction, New York Heart Association class, appropriate implantable cardioverter-defibrillator therapy, and all-cause mortality, were collected from the electronic health record. RESULTS: Of the study cohort, 350 patients (26.6%) were classified as the hypothyroidism group. The median duration of follow-up was 3.6 years (interquartile range, 1.7–6.2 years). Hypothyroidism was not associated with a higher risk of all-cause mortality in patients receiving CRT for heart failure. The risk of appropriate implantable cardioverter-defibrillator therapy significantly increased in association with increased baseline thyroid-stimulating hormone level in the entire cohort (hazard ratio, 1.23 per 5mIU/L increase; 95% CI, 1.01–1.5; P = 0.04) as well as in the hypothyroid group (hazard ratio, 1.44 per 5mIU/L increase; 95% CI, 1.13–1.84; P = 0.004). CONCLUSIONS: CRT improves cardiac function in hypothyroid patients. The ventricular arrhythmic events requiring ICD therapies are associated with baseline TSH level, which might be considered as an important biomarker to stratify the risk of sudden death for patients with heart failure and hypothyroidism.
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spelling pubmed-75099212020-09-24 Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure Yang, Mei Li, Xuping Morris, John C. Liang, Jinjun Deshmukh, Abhishek J. Hodge, David Li, Yigang Cha, Yong-Mei BMC Cardiovasc Disord Research Article BACKGROUND: Hypothyroidism is known to be associated with adverse clinical outcomes in heart failure. The association between hypothyroidism and cardiac resynchronization therapy outcomes in patients with severe heart failure is not clear. METHODS: The study included 1316 patients who received cardiac resynchronization therapy between 2002 and 2015. Baseline demographics and cardiac resynchronization therapy outcomes, including left ventricular ejection fraction, New York Heart Association class, appropriate implantable cardioverter-defibrillator therapy, and all-cause mortality, were collected from the electronic health record. RESULTS: Of the study cohort, 350 patients (26.6%) were classified as the hypothyroidism group. The median duration of follow-up was 3.6 years (interquartile range, 1.7–6.2 years). Hypothyroidism was not associated with a higher risk of all-cause mortality in patients receiving CRT for heart failure. The risk of appropriate implantable cardioverter-defibrillator therapy significantly increased in association with increased baseline thyroid-stimulating hormone level in the entire cohort (hazard ratio, 1.23 per 5mIU/L increase; 95% CI, 1.01–1.5; P = 0.04) as well as in the hypothyroid group (hazard ratio, 1.44 per 5mIU/L increase; 95% CI, 1.13–1.84; P = 0.004). CONCLUSIONS: CRT improves cardiac function in hypothyroid patients. The ventricular arrhythmic events requiring ICD therapies are associated with baseline TSH level, which might be considered as an important biomarker to stratify the risk of sudden death for patients with heart failure and hypothyroidism. BioMed Central 2020-09-23 /pmc/articles/PMC7509921/ /pubmed/32967613 http://dx.doi.org/10.1186/s12872-020-01693-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Yang, Mei
Li, Xuping
Morris, John C.
Liang, Jinjun
Deshmukh, Abhishek J.
Hodge, David
Li, Yigang
Cha, Yong-Mei
Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
title Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
title_full Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
title_fullStr Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
title_full_unstemmed Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
title_short Outcomes of Cardiac Resynchronization Therapy in Patients with Hypothyroidism and Heart Failure
title_sort outcomes of cardiac resynchronization therapy in patients with hypothyroidism and heart failure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509921/
https://www.ncbi.nlm.nih.gov/pubmed/32967613
http://dx.doi.org/10.1186/s12872-020-01693-w
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