The Korean journal of internal medicine

  • 제29권4호
  • /
  • Pages.454-465
  • /
  • 2014
  • /
  • 1226-3303(pISSN)
  • /
  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

Prediction of infarct severity from triiodothyronine levels in patients with ST-elevation myocardial infarction

  • Kim, Dong Hun (Department of Radiology, Chosun University School of Medicine) ;
  • Choi, Dong-Hyun (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Kim, Hyun-Wook (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Choi, Seo-Won (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Kim, Bo-Bae (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Chung, Joong-Wha (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Koh, Young-Youp (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Chang, Kyong-Sig (Department of Internal Medicine, Chosun University School of Medicine) ;
  • Hong, Soon-Pyo (Department of Internal Medicine, Chosun University School of Medicine)
  • 투고 : 2013.04.24
  • 심사 : 2013.10.28
  • 발행 : 2014.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: The aim of the present study was to evaluate the relationship between thyroid hormone levels and infarct severity in patients with ST-elevation myocardial infarction (STEMI). Methods: We retrospectively reviewed thyroid hormone levels, infarct severity, and the extent of transmurality in 40 STEMI patients evaluated via contrast-enhanced cardiac magnetic resonance imaging. Results: The high triiodothyronine ($T_3$) group (${\geq}68.3ng/dL$) exhibited a significantly higher extent of transmural involvement (late transmural enhancement > 75% after administration of gadolinium contrast agent) than did the low $T_3$ group (60% vs. 15%; p = 0.003). However, no significant difference was evident between the high- and low-thyroid-stimulating hormone/free thyroxine ($FT_4$) groups. When the $T_3$ cutoff level was set to 68.3 ng/dL using a receiver operating characteristic curve, the sensitivity was 80% and the specificity 68% in terms of differentiating between those with and without transmural involvement. Upon logistic regression analysis, high $T_3$ level was an independent predictor of transmural involvement after adjustment for the presence of diabetes mellitus (DM) and the use of glycoprotein IIb/IIIa inhibitors (odds ratio, 40.62; 95% confidence interval, 3.29 to 502; p = 0.004). Conclusions: The $T_3$ level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity.

키워드

참고문헌

  1. Docter R, Krenning EP, de Jong M, Hennemann G. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin Endocrinol (Oxf ) 1993;39:499-518. https://doi.org/10.1111/j.1365-2265.1993.tb02401.x
  2. Sypniewski E. Comparative pharmacology of the thyroid hormones. Ann Thorac Surg 1993;56(1 Suppl):S2-S6. https://doi.org/10.1016/0003-4975(93)90548-V
  3. Hamilton MA, Stevenson LW, Luu M, Walden JA. Altered thyroid hormone metabolism in advanced heart failure. J Am Coll Cardiol 1990;16:91-95. https://doi.org/10.1016/0735-1097(90)90462-X
  4. Opasich C, Pacini F, Ambrosino N, et al. Sick euthyroid syndrome in patients with moderate-to-severe chronic heart failure. Eur Heart J 1996;17:1860-1866. https://doi.org/10.1093/oxfordjournals.eurheartj.a014804
  5. Pingitore A, Landi P, Taddei MC, Ripoli A, L'Abbate A, Iervasi G. Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med 2005;118:132-136. https://doi.org/10.1016/j.amjmed.2004.07.052
  6. Eber B, Schumacher M, Langsteger W, et al. Changes in thyroid hormone parameters after acute myocardial infarction. Cardiology 1995;86:152-156. https://doi.org/10.1159/000176862
  7. Franklyn JA, Gammage MD, Ramsden DB, Sheppard MC. Thyroid status in patients after acute myocardial infarction. Clin Sci (Lond) 1984;67:585-590. https://doi.org/10.1042/cs0670585
  8. Friberg L, Werner S, Eggertsen G, Ahnve S. Rapid down-regulation of thyroid hormones in acute myocardial infarction: is it cardioprotective in patients with angina? Arch Intern Med 2002;162:1388-1394. https://doi.org/10.1001/archinte.162.12.1388
  9. Lymvaios I, Mourouzis I, Cokkinos DV, Dimopoulos MA, Toumanidis ST, Pantos C. Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: a strong association? Eur J Endocrinol 2011;165:107-114. https://doi.org/10.1530/EJE-11-0062
  10. Dimitriadis G, Baker B, Marsh H, et al. Effect of thyroid hormone excess on action, secretion, and metabolism of insulin in humans. Am J Physiol 1985;248(5 Pt 1):E593-E601.
  11. Lovejoy JC, Smith SR, Bray GA, et al. A paradigm of experimentally induced mild hyperthyroidism: effects on nitrogen balance, body composition, and energy expenditure in healthy young men. J Clin Endocrinol Metab 1997;82:765-770.
  12. Lebon V, Dufour S, Petersen KF, et al. Effect of triiodothyronine on mitochondrial energy coupling in human skeletal muscle. J Clin Invest 2001;108:733-737. https://doi.org/10.1172/JCI200111775
  13. Klemperer JD, Zelano J, Helm RE, et al. Triiodothyronine improves left ventricular function without oxygen wasting effects after global hypothermic ischemia. J Thorac Cardiovasc Surg 1995;109:457-465. https://doi.org/10.1016/S0022-5223(95)70276-8
  14. Gomberg-Maitland M, Frishman WH. Thyroid hormone and cardiovascular disease. Am Heart J 1998;135(2 Pt 1):187-196. https://doi.org/10.1016/S0002-8703(98)70081-X
  15. Pantos CI, Malliopoulou VA, Mourouzis IS, et al. Longterm thyroxine administration protects the heart in a pattern similar to ischemic preconditioning. Thyroid 2002;12:325-329. https://doi.org/10.1089/10507250252949469
  16. Dyke CM, Yeh T Jr, Lehman JD, et al. Triiodothyronine- enhanced left ventricular function after ischemic injury. Ann Thorac Surg 1991;52:14-19. https://doi.org/10.1016/0003-4975(91)91410-W
  17. Hsu RB, Huang TS, Chen YS, Chu SH. Effect of triiodothyronine administration in experimental myocardial injury. J Endocrinol Invest 1995;18:702-709. https://doi.org/10.1007/BF03349792
  18. Mahaffey KW, Raya TE, Pennock GD, Morkin E, Goldman S. Left ventricular performance and remodeling in rabbits after myocardial infarction: effects of a thyroid hormone analogue. Circulation 1995;91:794-801. https://doi.org/10.1161/01.CIR.91.3.794
  19. Wu KC. CMR of microvascular obstruction and hemorrhage in myocardial infarction. J Cardiovasc Magn Reson 2012;14:68. https://doi.org/10.1186/1532-429X-14-68
  20. Ugander M, Bagi PS, Oki AJ, et al. Myocardial edema as detected by pre-contrast T1 and T2 CMR delineates area at risk associated with acute myocardial infarction. JACC Cardiovasc Imaging 2012;5:596-603.
  21. Kim RJ, Shah DJ. Fundamental concepts in myocardial viability assessment revisited: when knowing how much is "alive" is not enough. Heart 2004;90:137-140. https://doi.org/10.1136/hrt.2003.023101
  22. Klem I, Kim RJ. Assessment of microvascular injury after acute myocardial infarction: importance of the area at risk. Nat Clin Pract Cardiovasc Med 2008;5:756-757. https://doi.org/10.1038/ncpcardio1373
  23. Choi KM, Kim RJ, Gubernikoff G, Vargas JD, Parker M, Judd RM. Transmural extent of acute myocardial infarction predicts long-term improvement in contractile function. Circulation 2001;104:1101-1107. https://doi.org/10.1161/hc3501.096798
  24. Wright J, Adriaenssens T, Dymarkowski S, Desmet W, Bogaert J. Quantification of myocardial area at risk with T2-weighted CMR: comparison with contrast-enhanced CMR and coronary angiography. JACC Cardiovasc Imaging 2009;2:825-831. https://doi.org/10.1016/j.jcmg.2009.02.011
  25. Yang HS, Lee CW, Hong MK, et al. Terminal QRS complex distortion on the admission electrocardiogram in anterior acute myocardial infarction and association with residual flow and infarct size after primary angioplasty. Korean J Intern Med 2005;20:21-25. https://doi.org/10.3904/kjim.2005.20.1.21
  26. Mather AN, Fairbairn TA, Ball SG, Greenwood JP, Plein S. Reperfusion haemorrhage as determined by cardiovascular MRI is a predictor of adverse left ventricular remodelling and markers of late arrhythmic risk. Heart 2011;97:453-459. https://doi.org/10.1136/hrt.2010.202028
  27. O'Regan DP, Ariff B, Neuwirth C, Tan Y, Durighel G, Cook SA. Assessment of severe reperfusion injury with T2* cardiac MRI in patients with acute myocardial infarction. Heart 2010;96:1885-1891. https://doi.org/10.1136/hrt.2010.200634
  28. Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002;105:539-542. https://doi.org/10.1161/hc0402.102975
  29. Tarantini G, Razzolini R, Cacciavillani L, et al. Inf luence of transmurality, infarct size, and severe microvascular obstruction on left ventricular remodeling and function after primary coronary angioplasty. Am J Cardiol 2006;98:1033-1040. https://doi.org/10.1016/j.amjcard.2006.05.022
  30. Gerber BL, Garot J, Bluemke DA, Wu KC, Lima JA. Accuracy of contrast-enhanced magnetic resonance imaging in predicting improvement of regional myocardial function in patients after acute myocardial infarction. Circulation 2002;106:1083-1089. https://doi.org/10.1161/01.CIR.0000027818.15792.1E
  31. Baks T, van Geuns RJ, Biagini E, et al. Recovery of left ventricular function after primary angioplasty for acute myocardial infarction. Eur Heart J 2005;26:1070-1077. https://doi.org/10.1093/eurheartj/ehi131
  32. Hombach V, Grebe O, Merkle N, et al. Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging. Eur Heart J 2005;26:549-557. https://doi.org/10.1093/eurheartj/ehi147
  33. Kim RJ, Wu E, Rafael A, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 2000;343:1445-1453. https://doi.org/10.1056/NEJM200011163432003
  34. Pantos C, Dritsas A, Mourouzis I, et al. Thyroid hormone is a critical determinant of myocardial perfor mance in patients with heart failure: potential therapeutic implications. Eur J Endocrinol 2007;157:515-520. https://doi.org/10.1530/EJE-07-0318
  35. Friberg L, Drvota V, Bjelak AH, Eggertsen G, Ahnve S. Association between increased levels of reverse triiodothyronine and mortality after acute myocardial infarction. Am J Med 2001;111:699-703. https://doi.org/10.1016/S0002-9343(01)00980-9
  36. Ozcan KS, Osmonov D, Toprak E, et al. Sick euthyroid syndrome is associated with poor prognosis in patients with STEMI undergoing primary percutaneous intervention. Cardiol J 2014 Mar 27 [Epub]. http://dx.doi. org/10.5603/CJ.a2013.0108.
  37. Pantos C, Mourouzis I, Cokkinos DV. Thyroid hormone and cardiac repair/regeneration: from Prometheus myth to reality? Can J Physiol Pharmacol 2012;90:977-987. https://doi.org/10.1139/y2012-031
  38. Pantos C, Mourouzis I, Cokkinos DV. New insights into the role of thyroid hormone in cardiac remodeling: time to reconsider? Heart Fail Rev 2011;16:79-96. https://doi.org/10.1007/s10741-010-9185-3
  39. Canadian Cardiovascular Society; American Academy of Family Physicians; American College of Cardiology, et al. 2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2008;51:210-247. https://doi.org/10.1016/j.jacc.2007.10.001
  40. Trepanier LA. Medical management of hyperthyroidism. Clin Tech Small Anim Pract 2006;21:22-28. https://doi.org/10.1053/j.ctsap.2005.12.004
  41. Wiersinga WM. Propranolol and thyroid hormone metabolism. Thyroid 1991;1:273-277. https://doi.org/10.1089/thy.1991.1.273

피인용 문헌

  1. Prediction of Infarct Transmurality From C‐Reactive Protein Level and Mean Platelet Volume in Patients With ST‐Elevation Myocardial Infarction: Comparison of the Predictive Values of Cardi vol.30, pp.6, 2014, https://doi.org/10.1002/jcla.21959
  2. The role of thyroid hormones in acute coronary syndromes: Prognostic value of alterations in thyroid hormones : Prognostic value of alterations in thyroid hormones vol.40, pp.8, 2014, https://doi.org/10.1002/clc.22689
  3. Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome? vol.110, pp.2, 2014, https://doi.org/10.5935/abc.20180019
  4. Value of the fT3/fT4 ratio and its combination with the GRACE risk score in predicting the prognosis in euthyroid patients with acute myocardial infarction undergoing percutaneous coronary interventio vol.18, pp.None, 2014, https://doi.org/10.1186/s12872-018-0916-z
  5. Free triiodothyronine and global registry of acute coronary events risk score on predicting long-term major adverse cardiac events in STEMI patients undergoing primary PCI vol.17, pp.None, 2018, https://doi.org/10.1186/s12944-018-0881-7
  6. Low free triiodothyronine is associated with contrast-induced acute kidney injury and long-term outcome in elderly patients who underwent percutaneous coronary intervention vol.21, pp.2, 2019, https://doi.org/10.14744/anatoljcardiol.2018.38228
  7. Acute myocardial infarction in young newbie bodybuilder using multiple steroid and protein supplements vol.21, pp.4, 2014, https://doi.org/10.1016/j.jccase.2019.11.010
  8. Acute coronary syndrome with severe atherosclerotic and hyperthyroidism: A case report vol.9, pp.27, 2014, https://doi.org/10.12998/wjcc.v9.i27.8127