| Japanese |
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| Title | 慢性心不全の血中甲状腺ホルモン動態 - ヨード有機化障害発現の可能性について - |
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| Subtitle | 原著 |
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| Authors | 松村憲太郎*, 中瀬恵美子*, 川合一良**, 斎藤孝行***, 橘川信忠***, 灰山徹*** |
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| Organization | *京都南病院循環器内科, **内分泌内科, ***放射線科 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 3 |
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| Page | 241-251 |
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| Year/Month | 1995/3 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」慢性心不全の甲状腺ホルモン異常発現頻度とヨード有機化障害による原発性甲状腺機能低下症との関連性について検討した. 左室駆出分画40%未満でNYHA III以上の慢性心不全127例, 左室駆出分画40%以上でNYHA II以下の一般心疾患1,079例を対象にした. 血中T3, T4, free-T4は慢性心不全群で有意に低く, TSH 5-15μU/mlの軽度TSH上昇は一般心疾患群4.08%, 慢性心不全群20.5%に見られ, 慢性心不全群で有意 (p<0.01) に高かった. ヨード有機化障害陽性は一般心疾患群5.26%, 慢性心不全群33.3%に見られ, 慢性心不全群で有意 (p<0.05) に多かった. TSHが上昇した慢性心不全で甲状腺open biopsyを施行し得た12例の組織像は非特異的な萎縮性変化のみで, 橋本病の所見はなかった. 慢性心不全に合併した原発性甲状腺機能低下症の原因に甲状腺の慢性循環不全による甲状腺peroxidase活性の低下やhydrogen peroxidase供給の減少によるヨード有機化障害が推測される. |
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| Practice | 臨床医学：一般 |
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| Keywords | Chronic heart failure, Low T3 syndrome, Low T4 syndrome, Hypothyroidism, Iodine organification defect |
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| English |
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| Title | Thyroid Hormones and Thyroid-Stimulating Hormone in Patients with Chronic Heart Failure - Relationship between Primary Hypothyroidism with Iodine Organification Defect and Chronic Heart Failure - |
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| Authors | Kentaro MATSUMURA*, Emiko NAKASE*, Ichiro KAWAI**, Takayuki SAITO***, Nobutada KIKKAWA***, Tohru HAIYAMA*** |
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| Authors(kana) | |
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| Organization | *Department of Cardiology, **Department of Endocrinology, ***Department of Radiology, Kyoto South Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 32 |
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| Number | 3 |
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| Page | 241-251 |
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| Year/Month | 1995/3 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Serum concentrations of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) were measured in 127 patients with chronic heart failure (CHF) (left ventricular ejection fraction ; <40% and NYHA ; III-IV), and 1,079 patients without CHF (non-CHF) (left ventricular ejection fraction ; 40%<= and NYHA ; I-II). Serum-T3, T4 and free-T4 were significantly decreased in patients with CHF. The prevalence of slight increase of serum TSH (5<=TSH<15μU/ml) were 20.5% in CHF and 4.08% in non-CHF. There was a statistically significant difference in the prevalence of slight increase of TSH (p<0.01). In the patients with slight increase of serum TSH, the 123I-thyroid scintigraphy and perchlorate test were performed 12 patients with CHF and 19 patients with non-CHF. The incidences of iodine organification defect were 33.3% in CHF and 5.26% in non-CHF. There was a statistically significant difference in the incidence of iodine organification defect (p<0.05). The histologic examination of thyroid biopsy specimen obtained 12 patients with CHF and primary hypothyroidism, these revealed only non-specific mild atrophic changes. Follicular damage and lymphocyte-infiltration were not evident. These findings suggest that the primary hypothyroidism were frequently complicated in CHF and associated with iodine organification defect by reduction of thyroid-peroxidase activity or decrease of hydrogen peroxidase. We conclude that the primary hypothyroidism with iodine organification defect was probably developed as a result of CHF. |
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| Practice | Clinical medicine |
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| Keywords | Chronic heart failure, Low T3 syndrome, Low T4 syndrome, Hypothyroidism, Iodine organification defect |
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