Nonthyroidal Illness Syndrome in Cardiac Illness Involves Elevated Concentrations of 3,5-Diiodothyronine and Correlates with Atrial Remodeling Article Swipe
Johannes W. Dietrich
,
Patrick Müller
,
Fabian Schiedat
,
Markus Schlömicher
,
Justus Strauch
,
Apostolos Chatzitomaris
,
Harald Klein
,
Andreas Mügge
,
Josef Köhrle
,
Eddy Rijntjes
,
Ina Lehmphul
·
YOU?
·
· 2015
· Open Access
·
· DOI: https://doi.org/10.1159/000381543
YOU?
·
· 2015
· Open Access
·
· DOI: https://doi.org/10.1159/000381543
Background: Although hyperthyroidism predisposes to atrial fibrillation, previous trials have suggested decreased triiodothyronine (T3) concentrations to be associated with postoperative atrial fibrillation (POAF). Therapy with thyroid hormones (TH), however, did not reduce the risk of POAF. This study reevaluates the relation between thyroid hormone status, atrial electromechanical function and POAF. Methods: Thirty-nine patients with sinus rhythm and no history of atrial fibrillation or thyroid disease undergoing cardiac surgery were prospectively enrolled. Serum concentrations of thyrotropin, free (F) and total (T) thyroxine (T4) and T3, reverse (r)T3, 3-iodothyronamine (3-T1AM) and 3,5-diiodothyronine (3,5-T2) were measured preoperatively, complemented by evaluation of echocardiographic and electrophysiological parameters of cardiac function. Holter-ECG and telemetry were used to screen for POAF for 10 days following cardiac surgery. Results: Seven of 17 patients who developed POAF demonstrated nonthyroidal illness syndrome (NTIS; defined as low T3 and/or low T4 syndrome), compared to 2 of 22 (p < 0.05) patients who maintained sinus rhythm. In patients with POAF, serum FT3 concentrations were significantly decreased, but still within their reference ranges. 3,5-T2 concentrations directly correlated with rT3 concentrations and inversely correlated with FT3 concentrations. Furthermore, 3,5-T2 concentrations were significantly elevated in patients with NTIS and in subjects who eventually developed POAF. In multivariable logistic regression FT3, 3,5-T2, total atrial conduction time, left atrial volume index and Fas ligand were independent predictors of POAF. Conclusion: This study confirms reduced FT3 concentrations in patients with POAF and is the first to report on elevated 3,5-T2 concentrations in cardiac NTIS. The pathogenesis of NTIS therefore seems to involve more differentiated allostatic mechanisms.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1159/000381543
- https://www.karger.com/Article/Pdf/381543
- OA Status
- bronze
- Cited By
- 65
- References
- 53
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W1602307529
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W1602307529Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1159/000381543Digital Object Identifier
- Title
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Nonthyroidal Illness Syndrome in Cardiac Illness Involves Elevated Concentrations of 3,5-Diiodothyronine and Correlates with Atrial RemodelingWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2015Year of publication
- Publication date
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2015-01-01Full publication date if available
- Authors
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Johannes W. Dietrich, Patrick Müller, Fabian Schiedat, Markus Schlömicher, Justus Strauch, Apostolos Chatzitomaris, Harald Klein, Andreas Mügge, Josef Köhrle, Eddy Rijntjes, Ina LehmphulList of authors in order
- Landing page
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https://doi.org/10.1159/000381543Publisher landing page
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https://www.karger.com/Article/Pdf/381543Direct link to full text PDF
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://www.karger.com/Article/Pdf/381543Direct OA link when available
- Concepts
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Medicine, Atrial fibrillation, Internal medicine, Cardiology, Sinus rhythm, Triiodothyronine, Thyroid function, Sick sinus syndrome, HormoneTop concepts (fields/topics) attached by OpenAlex
- Cited by
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65Total citation count in OpenAlex
- Citations by year (recent)
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2025: 4, 2023: 3, 2022: 4, 2021: 5, 2020: 5Per-year citation counts (last 5 years)
- References (count)
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53Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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