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RESEARCH ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 4  |  Page : 7

The association of subclinical hypothyroidism and pattern of circulating endothelial-derived microparticles among chronic heart failure patients


1 Consultant of Therapeutic Unit, Internal Medicine Department, State Medical University, Zaporozhye, Ukraine
2 Clinical Pharmacology Department, State Medical University, Zaporozhye, Ukraine
3 Cytofloumetry Department, Zaporozhye, Ukraine
4 Private Medical Center Vita-Center, Zaporozhye, Ukraine

Correspondence Address:
Alexander E Berezin
Consultant of Therapeutic Unit, Internal Medicine Department, State Medical University, Zaporozhye
Ukraine
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Source of Support: None, Conflict of Interest: None


DOI: 10.5812/cardiovascmed.29094

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Background: Subclinical hypothyroidism (SH) is diagnosed biochemically by the presence of normal serum free thyroxine concentration, in conjunction with an elevated serum thyroid-stimulating hormone level. Recent studies have demonstrated the frequent association between SH and cardiovascular diseases and risk factors. Objectives: To evaluate the impact of SH on patterns of circulating endothelial-derived microparticles, (EMPs) among chronic heart failure (CHF) patients Patients and Methods: This is a retrospective study involving a cohort of 388 patients with CHF. Fifty-three CHF subjects had SH and 335 patients were free from thyroid dysfunction. Circulating levels of N-terminal-pro brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), thyroid-stimulating hormone (TSH), total and free thyroxine (T4), and triiodothyronine (T3), and endothelial apoptotic microparticles (EMPs), were measured at baseline. SH was defined, according to contemporary clinical guidelines, as a biochemical state associated with an elevated serum TSH level of greater 10 μϋ/L and normal basal free T3 and T4 concentrations. Results: Circulating CD31+/annexin V+ EMPs were higher in patients with SH compared to those without SH. In contrast, activated CD62E+ EMP numbers were not significantly different between both patient cohorts. Using uni (bi) variate and multivariate age- and gender- adjusted regression analysis, we found several predictors that affected the increase of the CD31+/annexin V+ to CD62E+ ratio in the patient study population. The independent impact of TSH per 6.5 μϋ/L (odds ratio [OR] = 1.23, P = 0.001), SH (OR=1.22, P = 0.001), NT-proBNP (OR= 1.19, P = 0.001), NYHA class (OR=1.09, P = 0.001), hs-CRP per 4.50 mg/L (OR = 1.05, P = 0.001), dyslipidemia (OR=1.06, P = 0.001), serum uric acid per 9.5 mmol/L (OR=1.04, P = 0.022) on the increase in the CD31+/annexin V+ to CD62E+ ratio, was determined. Conclusions: We believe that the SH state in CHF patients may be associated with the impaired pattern of circulating EMPs, with the predominantly increased number of apoptotic-derived microparticles.


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