Thyroid Function and Gene Polymorphisms in Patients with Heart Failure.

Ioannis Vasiliadis, Genovefa Kolovou, Vana Kolovou, Maria Boutsikou



Objective: We evaluated nuclear factor kappa B {NFkB, rs28362491 [-94ins/delATTG (W/D)]} and angiotensin converting enzyme {ACE, rs1799752 [Ins(I)/Del(D)]} gene polymorphisms and their correlation with thyroid function in patients with heart failure (HF).
Design: Peak oxygen uptake (VO2) was evaluated (by Weber classification) during a symptom-limited cardiopulmonary exercise test in 194 patients. Thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and free (F) T3 and FT4 were also measured. According to their cardiovascular (CV) capacity, patients were subdivided into four groups: group A included patients with peak VO2 >20 ml/kg/min, group B 16-20 ml/kg/min, group C 10-16 ml/kg/min and group D 6-10 ml/kg/min. Patients were also genotyped for NFkB and ACE genetic variants.
Results: T3 was increased and FT3 was decreased for every in Weber’s classification (p=0.007 and p=0.012, respectively). Del carriers had elevated FT3 levels compared with Ins carriers (p=0.021). Patients with II genotype had elevated T4 levels compared with ID genotype (p=0.044). Both T4 and FT4 were decreased in D allele carriers (p=0.007 and p=0.045, respectively).
Conclusions: Thyroid hormones correlated with CV capacity. Associations between the NFkB and ACE gene polymorphisms and thyroid hormones levels were also observed. Further larger studies are required to clarify genes contribution in HF.

Keywords: Heart failure, T3, T4, TSH, gene polymorphisms, NF- nuclear factor kappa B (NFkB), angiotensin converting enzyme (ACE)