SUBCLINICAL HYPOTHYROIDISM AND HYPERTHYROIDISM IN PATIENTS WITH CONGESTIVE HEART FAILURE

OBJECTIVE: To determine frequency of subclinical hypothyroidism and hyperthyroidism in patients with congestive heart failure (CHF).METHODOLOGY: This descriptive cross-sectional study was conducted from 05-07-2010 to 04-07-2011, at cardiology department of Hayatabad medical complex, Peshawar. Adult patients of 15 years, diagnosed as CHF by using echocardiography were included. Exclusion criteria included patients taking thyroxin or antithyroid medications,dopamine, glucocoticoides, metoclopramide phenothiazines; thyroxine level 9pmol/L, triiodothyronine level 95 ng/dl or thyroxine level 24 pmol/L Triiodothyronine level 190ng/dl and diagnosis of sub-acute, painless or postpartum thyroiditis. History was taken and thorough clinical examination was performed. Diagnosis of CHF was confirmed through echocardiography by using Simpson’s method for calculating ejection fraction and by using pulse wave Doppler of mitral inflow and pulmonary venous flow. Serum TSH, free T4 and T3 levels were determined. Presence or absence of subclinical hypothyroidism and hyperthyroidism was ascertained in heart failure patients.RESULTS: Out of 753 patients, there were 431 (57.2%) male and 322 (42.8%) female patients. The mean age was 57.66±12.81 years. Subclinical thyroid disease was found in 46 (6.1%) patients including 26 (3.45%)males and 20 (2.65%) females. Subclinical hypothyroidism was found in 30 (3.98%) patients of CHF including 19(2.52%) males and 11(1.46%)females. Subclinical hyperthyroidism was found in 16 (2.12%) patients with CHF including 7(0.92%) males and 9(1.19%) females. Majority of subclinical hypothyroid (66.7%) and subclinical hyperthyroid (81.25%)patients were 60 years of age.CONCLUSION: Subclinical hypothyroidism and hyperthyroidism are not very common in CHF patients. Hypothyroidism was more frequent than hyperthyroidism.