Thyroid hormone, amiodarone therapy, and prognosis in left ventricular systolic dysfunction

• Published in: Journal of endocrinological investigation 2011-06, Vol.34 (6), p.e144-e148
• Main Authors: Coceani, M, Molinaro, S, Scalese, M, Landi, P, Carpeggiani, C, L'abbate, A, Iervasi, G, Pingitore, A
• Format: Article
• Language: English
• ISSN: 1720-8386
• DOI: 10.3275/7351

BACKGROUNDAmiodarone protects patients with left ventricular systolic dysfunction (LVSD) against serious arrhythmias, but it also has numerous side effects on non-cardiac organs, such as the thyroid. Indeed, amiodarone may inhibit the peripheral conversion of T₄ into T₃. Pathologically reduced serum levels of T₃ - the so-called "low T₃ syndrome" (LOWT3) - increase mortality in patients with LVSD and not on amiodarone. AIMThe aim of the study was to examine the relationship between thyroid hormone status, amiodarone therapy, and outcome in a population with LVSD. MATERIAL/ SUBJECTS AND METHODS: A total of 2344 patients with LVSD and free of overt hyper- and hypothyroidism were enrolled. The population was divided into 4 groups: group 1 (LOWT3 and amiodarone therapy, no.=126), group 2 (isolated amiodarone therapy, no.=74), group 3 (isolated LOWT3, no.=682), group 4 (controls, no.=1462). RESULTSKaplan-Meier curves showed, after a mean follow-up of 31 months, increased total and cardiac mortality in groups 1 (30% and 20%, respectively), 2 (23%, 11%), and 3 (22%, 12%) compared to group 4 (total mortality log-rank 82.8, p